HMI will provide the Client with a comprehensive review of SNF PPS requirements to improve billing accuracy, strengthen regulatory compliance, and assist in cost containment efforts. HMI will assist the facility to ensure all charges are captured appropriately, reimbursement is optimal for the services provided, and a schedule exists for filing MDS sheets and claims in a timely manner.

The scope of the engagement includes an on-site review of SNF records. The records and corresponding claims are reviewed for:

Eligibility criteria for SNF
Accuracy and completeness of documentation of services provided
Timing of assessments
Appropriateness of Resource Utilization (RUG) and Resident Assessment Protocols (RAP) assignment
Reporting OMRA and SCSA codes
Consolidated vs. excluded billing
How and when to bill Medicare Part B
Outcomes management
Value Added Benefits for this Service:

More knowledgeable staff
Quantifiable results
Added Feature:

Coding and Billing Helpline provided at no additional cost during the term of the contract. Client’s staff may take advantage of this helpful service to answer questions arising from coding and billing issues.