A thorough analysis of Medicare utilization including a review of billing accuracy according to the Medicare Benefit Policy Manual & Medicare Claims Processing Manual, documentation compliance and MDS coding to ensure claims and medical necessity are supported and Medicare skilled coverage criteria is met.
Coretactics can work with your team to develop processes and individualized education plans customized to meet your needs and address identified areas of missed billing opportunities.
A comprehensive review of your current systems & processes utilized to capture optimal and accurate reimbursement can lead to improved compliance, efficiency and minimize future missed opportunities. The expertise of our clinical and therapy consultants will allow your organization to maximize opportunities through sustainable processes and on-site education.
Coretactics offers support to providers when preparing for upcoming audits to ensure necessary supporting documentation is available and organized. Post-audit outcome analysis is also available to identify opportunities for process improvement.
Proper utilization and billing of services in accordance with multiple managed care contracts can be simplified utilizing our contract detail process and team education on resource management by payer source.
Whether you need assistance compiling documentation for responses or guidance to determine if a redetermination is warranted, our experts are available to work with you and your team to ensure optimal outcomes.
Our team can assist providers to identify potential causative factors in denials and develop targeted education on strategies to improve their processes through the use of tracking systems to monitor timeliness of ADR responses/status resulting in improved appeals and denials outcomes.