VCPI’s Clinical Consulting Services assist your company in improving both clinical and rehabilitation-related procedures. We provide a comprehensive approach by assessing your current processes and data related to Medicare PPS, RUGS III and IV, and rehabilitation, and then present you with our findings and recommendations.We quantify our findings for such areas as lost-revenue generating opportunities, lost revenue due to potential claim denials, cost reduction opportunities and survey risks due to documentation shortcomings. We can also tell you how you stack up against local and national competition, based on comparative data. Let us help you gain a competitive edge by optimizing reimbursement and enhancing survey results.

Clinical Assessment and Consultation:  

• Implementing efficient and effective clinical documentation processes/systems
• Utilizing an effective pre-screening and admitting process for residents under Medicare PPS and RUGs (III and IV)
• Selecting the most appropriate MDS assessment reference date that ensures appropriate payment under Medicare PPS
• Identifying significant condition changes
• Ensuring accurate scheduling of MDS assessments
• Attaining congruency between documentation systems and the MDS
• Defining the responsibilities of the MDS Coordinator and other center personnel in MDS/RAP completion

Rehabilitation Assessment and Consultation

• Determining appropriate RUGs (III and IV) level per initial evaluation/re-evaluation of the resident
• Determining appropriate resource utilization based on resident diagnosis/condition and RUGs (III and IV) level
• Validating the medical necessity of the assigned RUGs (III and IV) level
• Ensuring appropriate reimbursement and determining the efficiency of systems
• Validating medical necessity, frequency and duration of Medicare Part B services

Also see: Clinical Education Workshops