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 – Key Expectations, Common Survey Findings, Best Practices, and Steps to Consider to Ensure Survey Readiness

    Intravenous therapy in skilled nursing facilities care heightens clinical and regulatory risk. Surveyors frequently review IV therapy practices to evaluate compliance related to federal quality of care regulations, nursing standards, infection prevention requirements,...

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    Path to Five Star Quality Measures in 2026

    The MDS 3.0 Quality Measures User’s Manual v18.0, effective January 1, 2026, includes some notable changes to QM specifications and reporting expectations. In addition, MDS‑driven QMs are becoming increasingly impactful across Care Compare, Five‑Star Ratings, SNF QRP,...

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    Ask Proactive – It doesn’t appear that we’ve had any significant changes at our facility this past year. Do we still need to review or revise our Facility Assessment?

    Q: It doesn’t appear that we’ve had any significant changes at our facility this past year. Do we still need to review or revise our Facility Assessment?   A: Yes. Under F838, the Facility Assessment must be reviewed at least annually, even if no significant...

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