

Compliance
Compliance Program support for rehabilitation settings including program development, policies and procedures, auditing and monitoring and compliance investigation assistance. Learn more
Medical Review
ADR and Appeals management services for Medicare, Managed Care and Insurance claims. Proactive’s medical review team has a proven history of success of achieving successful outcomes for RAC, UPIC/ZPIC, TPE and Insurance reviews and in overturning denials. Learn more
Audit Services
Therapy QA review support services specializing in Medicare A, B and Insurance reviews for SNF Providers, TCU/Swing Bed Units, and Outpatient Therapy Clinics. Proactive offers medical record documentation reviews with emphasis on overpayment risk and current industry audit activities. An objective 14-point scale audit is available with individual clinician feedback highlighting examples of compliance in supporting care and coding, opportunities for improvement, and feedback on clinical treatment course progression.
Contract Therapy Vendor Sub-Contractor
Contact us to learn more about subcontracting PDPM QA audit services for your SNF clients
In-House SNF Therapy Program Management Support
Rehabilitation department support & oversight services for in-house therapy programs including:
- Department operations support
- Clinical program development in areas such as falls management, dementia care and weight loss
- Part B programming
- Quality assurance/compliance auditing of skilled therapy documentation
- On site treatment observations
- Training and education
Having Proactive as a routinely scheduled resource has allowed our facility to make positive change to an in-house program. Proactive doc audits, staff training, and regulatory reviews have all been an important part of our transition.
Ask Proactive – When does the state survey agency or CMS usually apply the remedy of a Directed Plan of Correction?
Q: When does the state survey agency or CMS usually apply the remedy of a Directed Plan of Correction? A: A Directed Plan of Correction (DPoC) is a remedy that provides for directed action(s) from either the State or CMS Regional Office (RO) that the facility...
BIG Changes to the Falls with Major Injury QM: What Changed and Why it Matters
BIG Changes to the Falls with Major Injury QM: What Changed and Why it Matters In the ever changing environment of quality reporting in healthcare, few metrics carry more weight than the Falls with Major Injury (FMI) measure. The Falls with Major Injury (FMI)...
Best Practices for Establishing and Honoring Code Status
Best Practices for Establishing and Honoring Code Status When a new resident arrives at your nursing facility, one of the most critical steps in the admission process is confirming and documenting their code status - the instructions for how medical providers...