Weatherbee provides customized, state-of-the-art consulting services that are unmatched in the hospice industry.
Clinical Record Audits
As the COVID-19 threat begins to wane and hospice operations return to normal, one of the greatest challenges ahead will be CMS' return to its pre-pandemic audit plan. Even though CMS paused all payment-related audit activity during the COVID-19 crisis, Weatherbee is confident CMS will resume its pre-payment (e.g., TPE) and post-payment audits (SMRC, UPIC, etc.) by issuing new audit requests as soon as the public emergency is over.
In order to mitigate your hospice's future payment-related risk, the Weatherbee Resources team is available to conduct a clinical record audit to evaluate your hospice's compliance with the conditions for payment before CMS resumes its auditing activity.
How good is your team's documentation? Do you have systems and processes in place to give you confidence that every bill submitted will result in payment?
Periodic external reviews of your documentation can identify potential issues before they become major problems.
Weatherbee's extensive expertise in conducting independent clinical record audits helps evaluate whether claims are billable and payable; identify problematic staff and team practices; and provides education and coaching aimed at improving audit outcomes over time, all of which substantially reduce your hospice's risk profile.
Our comprehensive approach is designed to identify issues and provide an action plan outlining specific ways to improve upon current practices.
Analyze census statistics to select clinical records for auditing and benchmarking against nationally published data
Evaluate eligibility-related forms to ensure that they are technically valid
Conduct a pre-billing audit of selected clinical records
Identify documentation-related and other Opportunities for Improvement (OFIs)
Evaluate internal systems and processes to ensure that they support proper billing
Develop and facilitate customized education as needed
Conduct additional clinical records audits in order to evaluate improvement
Weatherbee's goal is to provide a comprehensive analysis of your interdisciplinary team's documentation, and an action plan to address any identified problems.
Engaging Weatherbee will result in:
Assuring the validity of your hospice's documentation tools and forms; and;
Enhancing interdisciplinary competence with regard to discerning, documenting, and defending hospice eligibility.
Please contact Weatherbee for additional information regarding Clinical Record Auditing.