Frequently Asked Questions
Don't other companies do
this same thing?
It's not the same! We are specialists in Home Health Revenue Recovery. Others
offer scaled-down versions of our process as a sideline to their main business
of accounting, legal or other general consulting services. We won't try to sell
you a laundry list of services or try to change the way you run your business.
Others often limit their analysis to a just a few areas, while our
PPS Analysis EngineSM
lets us review all of your billing data and find revenue recovery opportunities
others miss. We'll review your SCICs, therapy threshold episodes, PEPs, LUPAs,
Outliers, and unbilled, rejected or terminated episodes. Many "billing reviews"
look only at your billing data and try to interpret errors from that.
We compare your data with your intermediary's data in
order to fully understand each claim. This is the
Revenue Recovery Review
SM
Talk with us first. Billing and
recovery is all
we do!
What if we've already
audited our billing, and we have good controls in place?
We love a challenge. We have
found money after other audits have been completed. Our
PPS Analysis EngineSM
automatically mines through data that is too difficult and time consuming to
sort out manually. All recovery, no matter how small, pays off when the up front
cost to you is minimal.
Why
do we need you, since our billers are very good and very experienced?
Recovery of missed Medicare
funds is not an indictment of your billing staff! Regulations, processes, rules
and deadlines are continually changing. Nurses, Therapists, and Aides come and
go. Meanwhile your Billers are trying to keep up. They don't have time to dig
back through old billing while trying to do their daily work. We'll
get your Billers caught up, fill the gaps in your billing system, and help your
Billers become aware of where money is being missed.
Doesn't our billing software
prevent all mistakes?
Good billing software is now a
must-have in the Home Health industry, but good software faces many of the same
issues as good people. As the rules of the game change, it's difficult and
expensive to keep up. Today's billing software has overwhelming capabilities,
but if not properly utilized, money can fall through the cracks. We can show you
where many of these cracks are and we can help you fill them.
Why shouldn't we just do
this ourselves?
Time is money. Can you afford
to have your clinical and billing personnel stop what they're doing and go back
through two years worth of charts and billing records? Even if you have the
extra staff, they don't have the tools or the training to find money they've
already missed once. Let us do it, we have the expertise and resources to get it
done.
Is this legal?
Everything we do is in
compliance with Medicare rules and regulations. We provide you with supporting
documentation to back up any changes or adjustments we recommend.
How
do we make the adjustments that you recommend?
No
problem. We provide specific instructions regarding each billing change we
recommend. Most agencies prefer to make the recommended changes themselves. This
keeps the agency's billing software consistent with the data submitted to
Medicare, and provides a valuable training opportunity to the agency's Billers.
Of course, we can make the changes ourselves if you prefer.
What
about HIPAA?
We comply with HIPAA privacy
rules throughout our review. We provide a customized Business Associate
Agreement to allow the exchange of information and destroy or de-identify all
protected information after the review is complete.
Home health is a very
competitive industry. How do I know my agency's confidential business
information will remain confidential?
We provide you with a
contractual agreement which includes a mutual
confidentiality agreement to insure that everyone's trade secrets remain
confidential. We're only interested in helping you recover missed revenue, and
we use any information we receive only for that purpose.
Do I have to pay up front?
We have a minimal fee that is
billed to you up-front to cover our up-front costs, but all other monies
collected are only billed to you once you have received payment.
| 
