Call 855.485.QIRT for more information

Call 855.485.QIRT for more information

Pre-Claim Reviews

CMS recently announced a possible revisit to prior authorization demonstration for home care agencies.    

  1. Expect approximately 40% decrease in agency numbers by end of CMS demonstration.   
  2. Some experts believe agencies will require 1.5 additional FTEs (1 RN and 1 clerical) for every 100 patient census.   
  3. Do not resubmit claims until all information is collected.    
  4. Be sure to attach the assigned pre-claim number to all final claims and resubmissions.    
  5. Consider outsourcing this service.  

The Solution

QIRT has formed a highly trained and credentialed Pre-Claim Review (PCR) Team. 

This team is specifically trained to review the documentation in the patient medical record related to the 5 Tasks.   

The team will utilize tools that will alert the agency that:    

  •  All documentation is in one place and the agency can submit to the intermediary OR    
  •  One or more pieces of documentation is still needed before submission.   

 The team will work with the agency to put the required documentation in one place. 

 

QIRT can provide:

  • Coding/OASIS review to ensure coding and assessment documentation relate to the F2F encounter and need for home care.  
  • PCRs independently. 
  • Coding/OASIS review and then PCR review.
  • Billing for the initial RAP with a review of documentation present at the time of RAP.

 

Let QIRT be your solution.

 

Free your staff to focus on what is necessary and important: 

  • Provision of care  
  • Documentation of care necessary for an auditor to form a picture about this specific patient   
  • Care needed by the patient, provided by the agency, and documented by the clinician.

Contact Us

QIRT leads the post-acute industry in coding, billing, and consulting. Serving agencies across the United States, QIRT provides multi-level coding/MDS/UAS reviews, quality assurance, appeals, outsourced billing, consulting, and education.

15 Verbena Avenue, Suite 210, Floral Park, NY 11001

855.485.QIRT (7478)

855.485.QIRT (7478)

516.706.3341

516.706.3341

Recent News

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    Monday, August 6, 2018


  • QIRT Introduces Quality Cycle Management to the Post-Acute Industry Learn More

    Monday, July 23, 2018


  • QIRT Launches Journey Program to Meet the Unique Needs of Post-Acute Agencies Learn More

    Monday, April 23, 2018


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