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 – Is the nursing home required to have Compliance and Ethics Program meetings with a certain frequency?
Q: Is the nursing home required to have Compliance and Ethics Program meetings with a certain frequency? A: While there is no requirement related to a specific meeting frequency at 483.85, the General Compliance Program Guidance states that “The Compliance...
LTC Smoking/Vaping Safety 101
LTC Smoking/Vaping Safety 101 As the use of tobacco and vaping products continues to evolve, nursing homes must address the unique challenges these habits pose to resident safety, health outcomes, and regulatory compliance. Whether accommodating individuals who...
Ask Proactive – Q: What are some scenarios in which an IDR (Informal Dispute Resolution) might be requested?
Q: What are some scenarios in which an IDR (Informal Dispute Resolution) might be requested? A: The IDR process gives nursing facilities one informal opportunity to dispute cited deficiencies after any survey of Federal requirements for participation. The...