Harmony Healthcare Blog

SPOT (Supportive Planning and Operations Team):  Fines or Feedback

Posted by Kathy Monahan on Tue, Jul 26, 2016


Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

In April of this year, the Massachusetts Department of Public Health (DPH) launched an initiative to identify underperforming nursing facilities and created a unit called “SPOT” to assist these “targeted” facilities with improving the quality of care through

  • Assessments,
  • Recommendations and
  • Support services inclusive of education and training.

However, according to The Globe February 11, 2016, “Massachusetts health regulators moved to significantly strengthen oversight of nursing homes, creating a unit that will conduct unannounced inspections and promising to impose fines on problem-plagued facilities.”

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Topics: Audits,, SPOT

Five Fundamental Steps for A Denial Free Medicare Audit

Posted by The Harmony Team on Thu, Jul 07, 2016

Probe, ZPIC, RAC auditors as well as other Medicare Medical Review auditors are quite active throughout the country reviewing PPS and Medicare Part B claims at skilled nursing facility sites.  The request for medical records whether paper or electronic can be a daunting task for providers. Precision and timing are of the essence for a successful review.  CMS considers medical review contractors as being responsible for detecting, deterring, and even preventing Medicare fraud and abuse.  In this capacity, the auditor is directly responsible for operating areas such as investigation, case development, administrative solutions, and referral to law enforcement. 

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Topics: Medical Record Review, Audits,, Denials

Want To Avoid an Audit? Remember to PREPARE

Posted by Washington Health Care Association on Thu, Oct 16, 2014

This is a featured guest blog article written by: 

WHCA - Washington Health Care Association


On Thursday, October 9th, Kris Mastrangelo, Owner and CEO of Harmony Healthcare, presented a webinar entitled “The OIG Report: Best Practices in Audit Prevention.” The report makes strong statements regarding alleged MDS inaccuracies, over coding, and billing by skilled nursing facilities. Mastrangelo outlined keys to success to help communities avoid audits and find success with their compliance programs with the acronym “PREPARE”:

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Topics: Documentation, OIG, Compliance, Audits,

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