Skilled Nursing Facility (SNF) Comprehensive Review

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.