Our comprehensive document reviews are only done by Registered Nurses to ensure the highest standards of quality. We review cases remotely and perform all our reviews using our Quality Review Tool software.Let's Connect
Our comprehensive document reviews are only done by Registered Nurses with master's degrees to ensure the highest standards of quality. We review cases remotely and perform all our reviews using our Quality Review Tool software.Let's Connect
Our Plan of Care (POC) review services guarantee the accuracy and completeness of documentation at the point of care. Our clinical team, comprised of Registered Nurses, meticulously assesses the POC for quality and compliance, delivering comprehensive feedback on identified areas for improvement.
We determine if beneficiaries meet home health coverage requirements for providers under Review Choice Demonstration, and package charts and submit to the Medicare Administrative Contractor (MAC).
The agencies we work with have been able to keep the affirmation rate above 95%, much higher than the required 90%.
We handle everything from Face-to-Face encounters to visit documentation reviews, verifying if the data is in accordance with Medicare coverage criteria and billing guidelines.
We also provide a statistical findings summary of the reviewed charts, at the provider, clinician, clinical manager, and physician levels on a monthly and/or quarterly basis. The report highlights trends that impact the organization and includes a multi-level analysis of the identified issues.
We help providers who receive additional documentation requests (ADR) with clinical documentation reviews to meet compliance standards, resulting in increased success rates and reduced payment delays.
We ensure timely completion at Start of Care (SoC) with Face-to-Face (FTF) encounter requirements review and check if it supports the patient's homebound status and skill needs.
A review at this step is critical for Medicare home health services eligibility certification and improves an agency’s compliance with the Conditions of Participation (CoP), significantly.
We determine appropriateness of services and provide summary reports that highlight presence of all CMS specific documentation and information. Reviews can be customized to suit your needs - SoC, Recertification, and Level of Care Documentation reviews. Our reports help providers gain valuable feedback on the support and training that their clinicians need to improve compliance.
We ensure compliance standards are met in an ever-changing regulatory environment and help you with documentation reviews to ensure that the conditions of participation and payment are met, when you recieve Additional Documentation Requests(ADR).
We perform quarterly audits and provide dashboards that help providers make proactive, informed decisions on areas that the team needs to improve on.
All chart reviews are done by Registered Nurses (RN) with a master's degree
All chart reviews are done by Registered Nurses (RN).
We are not the typical third-party vendor or partner. Rather, we are an extended arm of your company who knows that working together and building relationships is critical to our shared success.
We follow a meticulous multilevel process and thorough internal quality assurance checks to maximize accuracy in the work we do. Medical reviews are quality-checked on a daily basis and policies are in place to address concerns, should they arise.
In addition to multi-level quality control, we use a Quality Review Tool software for error-free reports.
Your success matters to us, which is why we keep our processes transparent, direct, reliable and affordable. That way you can continue to focus on enriching your client experiences, all while improving quality and optimizing operational costs.
Chief Compliance Officer - Mid-Sized Home Health Provider
"The Red Road consulting team is committed to quality assurance and excellence. They utilize a team of experts who focus on the careful review of clinical documentation to assure necessary regulatory criteria are met and the records reflects quality patient care services. The Red Road reviewers provide prompt service with timely feedback and maintain a close working relationship with our quality assurance team.”