Compliance Program support for rehabilitation settings including program development, policies and procedures, auditing and monitoring and compliance investigation assistance. Learn more
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.
Transitioning from QIES to iQIES for MDS Submission
To comply with federal security mandates, the Centers for Medicare & Medicaid Services (CMS) has initiated new security requirements for access control to CMS Quality Systems through Remote Identity Proofing (RIDP) via the Healthcare Quality Information System...
Ask Proactive – We have a resident on Enhanced Barrier Precautions who will be staying at our facility long term. Are there criteria for discontinuing these precautions at some point?
Q: We have a resident on Enhanced Barrier Precautions who will be staying at our facility long-term. Are there criteria for discontinuing these precautions at some point? A: It depends on why the Enhanced Barrier Precautions (EBP) were implemented. For...
Assessing Resident Capacity to Consent to Sexual Activity
The updated abuse guidance issued on June 29, 2022, stresses that facilities must take steps to ensure residents are protected from abuse, including evaluating whether the resident has the capacity to consent to sexual activity. To understand how to appropriately...