On Site Medical Record Review

Overview:

Preparing multidiscipline documents to submit for a Governmental record review is a daunting task. Many providers approach this task with less intensity than required. This may be due to a lack of experience, limited resources or a combination of the two. Anytime contact is made with a Governmental agency it is of utmost importance to put the best effort forward and impress the reviewers with facts of the case which clearly support the clinical decision making on behalf of the provider when possible.

Potential risks:

Facilities have five opportunities or levels of appeal to impress upon the reviewing entity the position of the provider in regards to claims under Governmental scrutiny.  Submission of a less than pristine appeal package sets the facility up for repeatedly receiving claim inquiries from the Medicare contractors.

How can Harmony Healthcare International Help?

HHI experts are trained to be meticulous and uncover every fact when preparing documents for medical record review. Through the HHI process, documents are often discovered in unexpected locations which support the skilled services provided. On-site reviews afford the facility the opportunity to have the Harmony experts explore every possible location seeking evidence to support denied claims as well as interview staff to reveal undocumented facts significant in the appeal preparation process.