Provider Management Solutions conducts on-site visits and analyzes various aspects of a provider’s financial & reimbursement systems.  These visits may vary in frequency from a one time consultation to a monthly/quarterly service or full management agreements.

• Admission Process:  Cash-flow improvement begins here.  PrMS will ensure the financial folder is complete and in full Medicare compliance. 
• Billing process:  Consists of a line item review of UB-92; clear pending claims, review no-pay bills, properly update the common working file.
• Month-end process:  Improves communication between nursing, rehab and the billing department.  Implement an effective triple check process.  Bill appropriate secondary payer and minimize write-offs. 
• Consolidated billing:  Review vendors’ services & invoices for possible PPS exclusions; determine benefit of services provided under arrangement. 
• Cost report preparation:  Prepare annual Medicare & Medicaid cost reports; conduct complete rate analysis; prepare interim rate review and interim cost reports.

Provider Management Solutions provides a full two-day site visit and analyze the following aspects of the rehab department.  These visits may vary in frequency from a one time consultation to a monthly or quarterly service.

• Staffing Model:  Current and historical patient caseloads are reviewed.
• Productivity:  A comparison is made to ensure that labor costs are minimized and that patients are receiving the optimal amount of treatment time.
• RUG Management:  An intensive audit is conducted on therapy’s RUG tracking systems, treatments provided, and MDS accuracy to ensure optimal reimbursement.
• Documentation: Charts are audited for compliance of Medicare skilled criteria.  This is critical to evaluate for the Denials Management Process.
• Medicare Part B Utilization: Review current and historic caseloads.  Focus on appropriateness of services and suggestions to maximize use of this population in the facility’s case mix.
• Communication Systems:  Review rehab’s verbal and written communications, the nursing referral process to therapy and the content of daily and weekly interdisciplinary meetings.
• Rehab Systems Financial Analysis:  Provider Management Solutions will assess the financial benefit of converting a therapy program to an in-house model or a contract model.