Skilled Nursing Facility Consulting
Overview:
Our core business is onsite medical record reviews. All recommendations are based on patient-specific, clinically-indicated services, combined with the supporting documentation. We identify areas of opportunity based upon direct caregiver observations, staff interviews, and clinical assessments, along with review of medical record documentation.
HHI Consultants review the RUG Classification obtained on the MDS 3.0 as a guide when auditing the associated medical record to affirm that the level of care and skilled services provided equate to the RUG-IV score billed on the claim. Our Audit Process far exceeds any other you will experience as our healthcare experts have the tenacity and persistence to perform in-depth, patient-specific medical record audits. We go to great lengths for our clients by spending extensive periods of time extracting the patient-specific detail. The result of this detail-oriented medical record review is a customized facility report, which is a resource for staff to conquer the constant challenge of enhancing patient care.
HHI believes that the foundation to increasing compliance is teaching staff to understand the core coverage components which in turn builds a great healthcare team. Our clients benefit from the Harmony in-house support staff who prepare a multitude of behind the scenes reports during and between facility site visits.
Medicare and Medicaid Compliance and Reimbursement Consulting
Harmony Healthcare International (HHI) is contracted by Long Term Care providers to provide onsite medical record reviews. HHI recommendations are based upon the clinical needs of the patient as supported in the documentation.
HHI Consultants utilize Federal Regulations for Medicare and Medicaid specific to Long Term Care published by CMS, as well as the guidelines provided in the MDS 3.0 RAI Manual User's Guide, to advise correction or affirmation of coding. HHI employs a team of seasoned clinicians (Occupational Therapists, Physical Therapists, Speech Language Pathologists and Licensed Nurses) who are trained and versed in Federal Survey Guidelines, Medicare Regulations, PPS, MDS, Case Mix, and Therapy Operations.
HHI Consultants review the RUG Classification obtained on the MDS 3.0 as a guide when auditing the associated medical record to affirm that the level of care and skilled services provided equate to the RUG-IV score billed on the claim. The RUG level (Resource Utilization Group) attained is representative of the resources necessary to provide care for the resident, within the Post Acute and Long Term Care environments. The MDS has over one thousand points of information that impact quality of care and accurate reimbursement.
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