Weatherbee provides customized, state-of-the-art consulting services that are unmatched in the hospice industry.
Clinical Record Audits
CMS has announced it will resume medical review activities (i.e., payment-related scrutiny audits) effective August 3, 2020, regardless of the public health emergency status.
The direct link to this information is: https://www.cms.gov/files/document/provider-burden-relief-faqs.pdf
With this information, Weatherbee fully expects both pre-payment and post-payment audits to resume in just a few weeks, so now is the time to ensure your team is ready! As always, the Weatherbee team is here to assist, if needed.
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.