Under SNF compliance regulations, Medicare has redefined the definition of fraud. When a facility has not taken all the necessary steps to ensure that all the technical and clinical qualifications are supported by medical records to prevent improper billing, fines and penalties may be applied.
In accordance with the mandated compliance program directive per CMS, Harmony Healthcare International, Inc. (HHI) provides compliance services including compliance-focused risk analyses, compliance officer services, compliance plan and policy development, audit and monitoring and ongoing education and training.
Facility-specific data is critical to ensure clinical and regulatory requirements are met or exceeded according to laws, rules and in accordance with best practices. Without timely and appropriate facility analyses, it becomes hard to ensure accurate and appropriate reimbursement.
Harmony Healthcare International, Inc. (HHI) provides a multitude of analysis services that highlight a facilities and strengths and weaknesses. Our services include analyses of Five-Star Quality Rating System, CASPER Report, PEPPER, Clinically Anticipated Stay, Staffing, Medicare Rugs, Medicaid Revenue and more.
The Affordable Care Act (ACA) introduced additional provisions aimed at preventing and reducing fraud, waste and abuse. As a result of participation in federal health care payment programs, long-term care facilities have become the target of frequent audits from various sources, including MAC, RAC and ZPIC, among the growing list.
Harmony Healthcare International, Inc. (HHI) audit services help to identify compliance areas that place providers at risk for repayment of monies to the state and federal government for services provided. These proactive audits allow facilities to avoid the potential for false claims and associated fines.
Securing accurate reimbursement in the Post-Acute arena can be particularly challenging due to the complex nature of the care and services provided to each patient; the complex methodologies that are required for each payer; the number of employees and technological systems; the financial, regulatory and civil penalties associated with noncompliance and so on.
Harmony Healthcare International, Inc. (HHI) brings an in-depth knowledge of the governmental reimbursement process, federal and state regulatory requirements, denials/appeals management and prevention, financial and clinical challenges
Keeping up with the ever changing regulations in healthcare in order to stay compliant can be an overwhelming challenge for facilities. Harmony HealthCARE Specialists can assist facilities with managing the revolving door of changes in a variety of ways.
Harmony Healthcare International, Inc. (HHI) has developed proprietary tools to assist you with evaluating overall quality, compliance and systems. Upon completion, our Harmony HealthCARE Specialist can assist you with development of quality assurance improvement plans for each focus area.
At a minimum, skilled nursing facilities must familiarize themselves with industry standards, examine current systems and prepare to evaluate and improve areas that are not in compliance or trigger concern. Keeping staff certified and up-to-date with regulatory changes has become a job in itself.
Harmony Healthcare International’s, Inc. (HHI) mission is to educate all healthcare disciplines on the rules and regulations surrounding service delivery in the long-term care arena, in order to ensure that all residents achieve his or her highest practical state of well-being per OBRA '87. Live webinar and/or video/audio conferences are also available.
As the industry shifts towards a pay-for-performance system, value-based purchasing is becoming part of the Five-Star Rating system. Nursing homes are facing significant risks that have their basis in the current regulatory system, reimbursement programs and market forces.
Harmony Healthcare International’s, Inc. (HHI) efficiency assessments include a review of general operations, an analysis of all billing services, an evaluation of reimbursement structure and recommendations, staffing assistance and for revenue enhancements /cost reductions based on current utilization.
Keeping up with the ever-changing regulatory world in healthcare can be an overwhelming challenge for facilities.
Harmony Healthcare International, Inc. (HHI) has developed proprietary tools to assist you with evaluating overall quality, compliance, and systems.
Our team of experienced HealthCARE specialists partner with all levels of the interdisciplinary team in an effort to affect change.
