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 – We are caring for a resident who recently admitted with a new G-tube. Can I code the G-tube site as a surgical wound in Section M?
Q: We are caring for a resident who recently admitted with a new G-tube. Can I code the G-tube site as a surgical wound in Section M? A: The RAI describes surgical wounds as any healing and non-healing, open or closed surgical incisions, skin grafts, or...
F761 – Maintaining Compliance through Strong Partnerships
F761 – Maintaining Compliance through Strong Partnerships Maintaining compliance with F761 – Storage and Labeling of Drugs and Biologicals requires ensuring medications are properly stored, secured, and destroyed based on state and federal guidelines....
Ask Proactive – Each skilled nursing facility arranging for the provision of hospice care under a written agreement must designate a member of the facility’s interdisciplinary team who is responsible for working with hospice representatives to coordinate care to the resident provided by the LTC facility staff and hospice staff. What do those responsibilities entail?
Q: Each skilled nursing facility arranging for the provision of hospice care under a written agreement must designate a member of the facility’s interdisciplinary team who is responsible for working with hospice representatives to coordinate care to the resident...