Clinical Reimbursement

At HealthPRO Heritage, we optimize reimbursement outcomes.

In today’s complex regulatory environment, we provide invaluable reimbursement consulting services. Whether you’re currently engaged with HealthPRO Heritage for therapy management services, or your facility is in need only of this specialized service, we provide customized clinical, operational, and financial solutions.

As respected subject matter experts, we have perfected a targeted approach that optimizes reimbursement and revenue capture. The approach prioritizes accurate and compliant management of the MDS process, while managing costs, improving efficiencies, and delivering high quality care.

We offer a variety of programs and services that assess current performance and identify opportunities for improvement. This may include on-site MDS and case-mix reimbursement reviews or our unique, real-time hotline service.

After conducting both on-site and remote assessments, we evaluate the following areas and develop a tactical operational plan that will improve resource utilization and compliance, ensure effective processes, and mitigate the risk of audit.

  • MDS coding accuracy & compliance
  • Restorative nursing program support
  • Optimal capture of clinical RUGs for case-mix
  • Enhancing/Ensuring appropriate length of stay
  • Optimal RUG & ADL scoring accuracy
  • Skilled nursing documentation support
  • Pre-Employment MDS coordinator position interviews
  • Diagnosis coding support for accuracy
  • Medicare regulatory updates & guidance
  • Improved pre-admission screening process

For more in-depth clinical reimbursement and compliance consulting, call us at 410.667.7200 or email us to learn more.