DRIVE QUALITY. REDUCE RISK.
Navigating the world of health care reform can be difficult for many post-acute care providers in long term care. Poor care collaboration between nursing and therapy, lack of communication, ineffective processes and lack of education can put providers at risk for survey tags and medical review risk. Now more than ever, you need trusted partners who are looking out for your best interests.
Your Documentation is Only as Good as Your Treatment.
Clinical documentation is a reflection of the skilled services provided. HTS focuses on core assessment and treatment standards that are fundamental to demonstrating rehab medical necessity. Quality care standards are advanced by hardwired compliance oversight processes including 3rd party audits.
Did You Know?
When clients are surveyed on why they partner with HTS, the #1 response is that we are an ethical provider who is focused on quality. Through careful monitoring and expert program oversight, we are focused on providing outcome-driven rehabilitation to drive quality while reducing medical review risk.
Medical Review? Let us take it from here.
In order to best support our clients, HTS utilizes a 3rd party, independent auditing team that assists in not only medical review but also to clean-up Medicare processes and facilitate best practice approaches for an optimal SNF experience for staff and patients. With a 97% success rate at the ALJ level and less than a 3% error rate company wide. HTS is fully invested with education on an on-going and on-demand basis. Our commitment is to excellence.
You can count on us for services that yield results as proven by our 6-prong approach:
- Established compliance program based on the standard 7 compliance elements
- Complete management of medical review requests (ADRs)
- Expert representation for appeals including ALJ hearings
- Targeted documentation training focused on areas of high risk medical review
- Audits performed on 14 documentation measures that define medical necessity and support for reimbursement
- Specific risk assessment including PEPPER Analysis
- Rehab RUG support and compliance systems
Services Only HTS Clients Receive
- PDPM Transition Partnership including system optimization and tools for successful IDT collaboration
- 5 Star Improvement
- Quality Measure Focused Clinical Programs
- Partnership with Quality Assurance Performance Improvement (QAPI)
- Third Party Medical Record Audits & Supportive Documentation Improvement
Ensure Compliance with Regulatory Standards
HTS partners with Proactive Medical Review, a third party company who specializes in ensuring compliance with regulatory standards and promoting measurable care excellence. The team includes SNF experienced nurse, MDS, Health Facility Administrator, therapist and reimbursement specialists with experience serving in multi-site contract therapy operations, as corporate directors of quality, clinical program specialists, and Compliance Officers. Proactive is uniquely positioned to assist in managing the many changes and challenges facing providers partnered with HTS. We are your local source for reimbursement accuracy and regulatory compliance.
As part of the commitment to partnering for compliance and care excellence, HTS has engaged Proactive Medical Review to conduct a Quality Assurance site visit. The site visit includes a compliance review of:
- Medicare processes
- Medical record documentation to support rehabilitation claims
- Observation of rehab treatments
- Medicare Meeting process
- Opportunity for targeted facility staff training
Analysis of facility data based on reports such as:
- PDPM Financial Impact Analysis
- SNF PEPPER
- Case Mix Index (CMI)
- 5 Star Provider Rating
- CASPER Facility Level QM Report
First in Line
HTS Partners are also the first to be notified of Proactive Medical Review’s training programs:
- Survey Management, including Mock Surveys
- MDS Coding Support Services
- Requirements of Participation (RoP) Partnerships (Phase 3 effective November 28, 2019)
- SNF Compliance Programs including Interim Compliance Officer Assignments
- Staff Development including Competency Based Training and Skills Assessment Clinics
Training Tools and Webinars
We offer complimentary tools and training for our partners. Learn more about current training here.