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
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
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.
As leaders in the nursing home industry, ensuring the well-being and safety of residents is paramount. One of the most challenging aspects of this responsibility is investigating allegations of abuse and neglect within our facilities. In this article, we will explore...
Q: When is it appropriate to use staff interviews on the MDS? A: For the four interviews on the MDS (BIMS, PHQ2/9, Activities, and Pain), direct resident input should be the primary approach as observations may be misleading. For instance, the RAI manual...
Behavioral health issues in skilled nursing facilities (SNFs) require meticulous documentation to ensure proper care and compliance with regulations. Accurate documentation not only facilitates effective treatment but also helps in addressing legal and regulatory...