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 – How does oral care impact the risk of death in a nursing home?
Q: How does oral care impact the risk of death in a nursing home? A: Aspiration pneumonia is a leading cause of death in nursing homes. Aspiration pneumonia occurs when a non-air substance (e.g. food, liquid, saliva) and bacteria from the mouth is...
DON Success: Delegation of Duties
As the acuity and complexity of long-term care residents has increased, the responsibilities of the Director of Nursing (DON) have also escalated significantly. The duties of the DON are not just clinical in nature, they also involve regulatory, reimbursement, and...
Ask Proactive – How long does CMS’ Abuse Icon remain on Care Compare?
Q: How long does CMS’ Abuse Icon remain on Care Compare? A: Criteria that identify a facility of non-compliance related to abuse, and placement of the Abuse Icon on Care Compare includes: Harm-level abuse citation in the most recent survey cycle:...