Burden of Care and Medical Necessity Documentation Audit (IRFs)
Assist rehabilitation providers in closing the documentation
gap that leads to discrepancies between burden of care and
Pinpoint vulnerabilities in hospital documentation that may
increase risk of MAC payment denials
Identify opportunities for improving documentation
and IRF-PAI coding to accurately reflect the burden of care
Ensure that documentation proves medical necessity
Educate staff and physicians to retain ongoing
Develop a strategic plan to secure the reimbursement
that matches the care rendered
Before we arrive on-site we analyze eRehabData reports and
historical data including coding and FIM scoring processes (eRehabData subscribers).
On-site we examine the components of the case mix index
to determine which of the financial drivers and quality measures
are trailing benchmarks through outcomes data review.
Armed with that analysis we can effectively assess the care delivery
and case management process.
Finally, we review the documentation to identify missed
reimbursement opportunities due to either inaccurate coding
of rehab impairment groups, etiologic diagnoses, or comorbidities,
or due to inaccurate FIM scoring.
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