October 16, 2018 (Floral Park, NY) - QIRT (Quality In Real Time), a leading provider of revenue cycle management and consulting for post-acute agencies, is introducing a new Review Choice Demonstration (RCD) Task Tool and accompanying RCD Team. The sole purpose of this tool and team is to aid home care agencies in complying with the new CMS standards. More than a year after pausing the program, CMS has announced a restart to the pre-claim review (PCR) demonstration project for home health agencies in five states in the form of Review Choice Demonstration (RCD) for home health agencies. Agencies in Illinois, Florida, Texas, Ohio and North Carolina will have to adjust to meet new industry standards.
Formerly known as the Pre-Claim Review, the RCD’s purpose is to stop the "pay and chase" model of claims reviews and shift the model to preventing payment for non-eligible services. RCD will put tremendous pressure on compliance with the certification requirements for home health, including the plan of care, orders for care, and the physician face-to-face encounter documentation. For this reason, QIRT created the RCD Task Tool. QIRT's RCD Task List Tooloffers a division of labor by splitting tasks between clinical and clerical to ensure timely claim affirmation and submission for billing. It also requires key items to be checked off when completed before allowing for claim submission, thus preventing non-affirmation of the claim. QIRT is also introducing its RCD Team to help relieve pressure from agencies that may suffer from this new protocol. QIRT’s team is trained to review documentation specific to CMS’ new requirements. This collaboration between agency and QIRT boosts success rates and speeds completion times.
“New policies such as ICD-10 coding changes, OASIS-D transition, plus the reinstatement of RCD will add a significant administrative burden for agencies,” says QIRT President and CEO, Laura Page-Greifinger.“Based on our estimates from last year’s PCR demonstration, agencies would need to add an estimated 1.5 additional FTE (full time equivalent employee). The sole purpose behind the RCD Task Tool and our RCD team is to fill this gap and support home care agencies. By outsourcing to QIRT, these agencies will be able to focus on what’s most important: their patients.”
QIRT’s highly trained team will review documents in the patient's medical record related to CMS requirements. The team will alert agencies when all the documentation is in one place and ready for submission or if one or more pieces are still needed before submission. Either way, QIRT can handle the preliminary steps to the new RCD requirements leaving agency staff to focus on patient care.
In 2006, QIRT was founded by President/CEO Laura Page-Greifinger, BSN, MPA who worked within the post-acute provider space for over 30 years as a nurse, supervisor, and clinical consultant. QIRT's initial service was providing home care agencies with multiple types of quality assurance reviews and coding. QIRT has since expanded services to the entire post-acute space including coding and OASIS review, quality assessment review, RCM and A/R Recovery, QAPI audits, and ADR response.
Only QIRT's Advantage Platform tracks processes with real-time checkpoints and Quality Cycle Management (QCM) tools along the journey to compliance and success. QCM provides a formal, systematic resolution to manage all aspects of the organization’s quality, reliability and risk throughout all workflow, from intake to discharge/re-certification per episode. It lends itself to a culture of excellence in the agency. Organization leaders can identify in real time which teams, clinicians, or outcomes are impacting the organization and can benchmark performance at all levels in all departments/teams. QCM unites the business and clinical sides of healthcare by coupling administrative data with treatment and outcomes.
QIRT's employees undergo vigorous vetting prior to hire and continued oversight and monitoring monthly to maintain top-notch compliance. The company works 24/7/365 days a year.
In 2018, QIRT was named to the 2018 Inc. Magazine 500/5000 List of Fastest Growing Companies for the sixth consecutive year. Inc. Magazine reports that companies making this list have, on average, grown six-fold since 2013 in the face of an economy that grew just 6.7 percent during that time. Of the thousands of companies who have applied for this distinction, only 7% have made the list five times, placing QIRT on the Inc. 5000 Honor Roll.