Clinical Record Audits

Outsourced Quality Assurance

Mitigate Risk!  Improve Outcomes!  Ensure Reimbursement!

We provide a wide array of Clinical Record Audits to help home health and hospice agencies mitigate financial and compliance risk and to improve accuracy for better quality and financial outcomes.

Our services are highly customizable to meet your needs:

  • We provide concurrent audits on either a short term or ongoing basis, to help you educate and/or augment your QA staff, and
  • We perform targeted Clinical Record Audits that include our recommendations to show you where you stand and what you need to improve

Our expertise includes Conditions of Participation, Medicare eligibility/payment criteria, documentation best practice, prebilling requirements, ICD-10, the OASIS assessment and the Hospice Item Set. Specific results include:

  • Compliance with Conditions of Participation
  • Appropriate documentation of Medicare qualifying criteria such as initial and ongoing homebound status, skilled care, support for and coordination of care, face-to-face, and appropriate utilization of services
  • Timely and accurate Hospice eligibility documentation
  • Evaluation of the quality of the plan of care to help ensure the documentation tells the story of each patient and supports the services provided
  • A summary of our findings and recommendations which highlight areas that require attention and education

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