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Medicare Audits/Medicaid Audits
This process assesses current processes related to Medicare PPS and/or Medicaid. This includes a three-phased approach including: Clinical Assessment and Consultation, Rehabilitation Assessment and Consultation, and Financial Assessment and Consultation for Medicare PPS. A facility may choose to complete one or all of the phases.
The Medicaid Assessment includes the Clinical Assessment and Consultation phase only.
Clinical Assessment & Consultation
Boyer & Associates will meet with the facility staff to understand and assess current processes related to Medicare PPS and/or Medicaid.
Assessment areas include resident admission process, the MDS scheduling and completion process, accuracy and consistency of documentation in the clinical record, and communication process, accuracy and consistency of documentation in the clinical record, and communication processes between clinical, billing and areas of clinical practice.
Rehabilitation Assessment & Consultation
A Boyer consultant will meet with the facility staff to understand and assess current rehabilitation processes as they relate to Medicare PPS and Medicare Part B coverage and documentation. During our visit, we will review resident charts to evaluate therapy practices and documentation.
Financial Assessment & Consultation
This phase is completed off-site after the completion of the onsite clinical and/or rehabilitation assessment, quantifying the results of the assessment.
Assessment areas include: Medicare secondary payer processes, denial letters and expedited review process, uniformity of charge structures, billing practices, Medicare Log maintenance, medical review practices and denials management.
* 16655 West Bluemound Road * Suite 280 * Brookfield, WI 53005 * 262.754.0525 * info_boyerandassociates.com *
