OASIS Reviews

Frequently, Medicare review contractors are pointing to OASIS data contradiciting itself or not supporting skilled needs as a reason for claim denials.  A detailed and concise review of OASIS assessments by our consultants helps agencies ensure that Medicare start of care and re-certifications are not simply complete.  An OASIS review conducted by our consultants identify weakness in documentation of medical necessity, skilled need, and homebound elements.  OASIS review services include a full review of OASIS documentation with written feedback to the agency.  Most OASIS review services are conducted and returned to agencies within 24-48 hours on average.   

 

Face-to-Face Review

Face-to-Face Encounter documentation continues to be one of the number one reasons for claim denials.  Brooks*Acevedo consultants offer Face-to-Face documentation review with written feedback.  Under Federal regulations all certification periods following a start of care that contains an invalid face-to-face encounter documentation are non-billable.  Our consultants utilize the latest guidance in reviewing an agency’s face-to-face documentation to help protect an agency’s future billing. Contact one of our consultants today to discuss how ongoing Face-to-Face reviews can benefit your agency in ensuring current and future billing meets all billable guidelines.

 

Therapy Evaluation Review

Medicare therapy services also continue to be highly targeted for pre and post-payment reviews.  Therapy evaluations are usually thought to be one of the less burdensome documentation requirements.  However, failure to document evaluations strictly by Medicare guidelines as well as following Local Coverage Determinations can lead to entire claims for therapy services being denied.  Our consultants offer review of therapy evaluations prior to and after physician signature to ensure full compliance with Medicare and LCD standards.  

Brooks Acevedo Attorneys at Law

Defending the rights of health care providers since 2008

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(713) 777-7332


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