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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.
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.
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 is a reality. HTS is committed to ethical practice and confidently stands with partners through payer audits. In fact, HTS manages the cumbersome ADR and Appeals process and maintains less than a 2% recoupment rate under medical review.
HTS is dedicated to improving quality, compliance and implementing strategic solutions for each community. Our strong oversight, clinical programming and attentive leadership results in a quality-driven infrastructure that gleans exceptional quality outcomes. HTS supports quality measure improvement through precision clinical programs that drive 5 star quality.
• Established compliance program based on the standard 7 compliance elements
• Individualized assessment and plans of care based on identified clinical complexity
• Precision clinical programming to facilitate highly skilled therapy interventions
• External expert pre-bill documentation auditing
• Companywide documentation quality standards and metrics
• Access to both therapy and industry relevant training to attain and maintain compliance
• QAPI Support and Rehab Integration into facility quality efforts
• Strong Therapy program oversight through IDT collaboration, Regional Director support and independent MDS/AANNANC certified consultants
Medical Review? Let us take it from here.
In order to give our clients, the ultimate support needed in the instance of medical review, HTS utilizes a 3rd party, independent auditing team that assists every step of the way. We have a 97% success rate at the ALJ level and less than a 3% error rate company wide. We are fully invested with regular education and auditing of therapy documentation and nurse-to-therapy chart reviews.
• Complete management of medical review requests (ADRs) and appeals
• 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
• PEPPER Analysis
• Rehab RUG support and compliance systems