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
    What our clients say about us…

    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. 

    Michelle Perry

    Administrator, Evansville Protestant Home

    Learn more in our blogs

    Ask Proactive – What should be considered when assessing a resident’s safety with hot liquids?

    Q: What should be considered when assessing a resident’s safety with hot liquids?   A: Several factors that should be considered for all residents in determining safe ingestion of hot liquids including: Is there any history of spills or injuries related to hot...

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    Behavior Tracking & Trending to Drive Better Care Management

    In long-term care, behaviors are often one of the earliest signs that something has changed with a resident. Agitation, wandering, refusal of care, exit-seeking, verbal outbursts, sleep disruption, repetitive questioning, or sudden withdrawal are rarely “just...

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    Ask Proactive – My facility Long-Stay antipsychotic percentage increased on my 2026 Quality Measures. What are some best practices for reviewing Psychotropic medications?

    Q: My facility Long-Stay antipsychotic percentage increased on my 2026 Quality Measures. What are some best practices for reviewing Psychotropic medications?   A: It is possible the increase in your QM percentage is not due to a true increase in antipsychotic...

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