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.
Compliance Rounding for Survey Readiness
Is your facility survey ready? According to CASPER (9/17/23), nearly 12% of the nation’s LTC facilities have not had a recertification survey in over 24 months. The states with the highest percentages include: Kentucky – 76.3% Maryland – 73.3% Idaho – 67.9% Alabama –...
Ask Proactive – How should you sanitize a glucometer when used for different residents?
Q: How should you sanitize a glucometer when used for different residents? A: To prevent the spread of pathogens among residents and to avoid a possible F880 citation, it’s vital to clean the glucometers both before and after each resident’s use. Blood...
SNF Certification/Recertification Compliance Check Up
MACs have begun rolling out the mandated 5-Claim Probe and Educate audit and will eventually review claims for every eligible SNF in their jurisdiction. SNF certifications and recertifications are important elements of SNF Medicare stay compliance and will be...