Kelly Simonelli

Compliance Programs – How to Identify Gaps and Know Your Organization’s Risks

When was the last time your organization completed a compliance risk assessment or gap analysis? When was the last time your organization had a risk assessment or gap analysis completed by an external vendor? A risk assessment is the process of reviewing and identifying any risk areas and the consequences that could result if the identified risks were to occur. By completing these assessments, organizations are aware of these potential risks and can prioritize any…

How to Improve Clinical Documentation Using ChartVerify®

Has your organization noticed an increase in documentation requests from insurance payers? If so, you’re not alone—and if not, you most likely will. As the health care industry continues to shift from payment based models to value-based care, one thing is certain, providers are considering how to handle the increased administrative burden to stay in compliance with the changes. These changes have many therapy providers considering their options, including preparing their practices for possible sale…

Inpatient Rehabilitation Review Choice Demonstration Project: Cycle 1 Progress in Pennsylvania

The content of this blog is primarily for those who are Inpatient Rehabilitation Facilities (IRF) or Inpatient Rehabilitation Units (IRU), however, the overarching theme is a good reminder for all healthcare providers. The takeaway is this: Whatever the MAC says goes! Regardless of your interpretation of the Centers for Medicare and Medicaid (CMS) regulations printed in the Medicare Benefit Policy Manual (MBPM), or wording in old transmittals, if the Medicare Administrative Contractor (MAC) has a…