Call 855.485.QIRT for more information

Call 855.485.QIRT for more information

Dark gray icon with a white magnifying glass, indicating The detailed work QIRT Compliance services provides    Home Care & Hospice Compliance Services

Accuracy first, success will follow.

Compliance in home care and hospice is about the act of documentation. ADR Reviews, ZPICS, UPIC, the newest revision of PCRs, all require documentation for accurate appeals. The only way to comply with Medicare and Medicaid regulations is to be certain that case documentation is accurate and complete. Compliance is essential to your agency’s Quality Cycle Management (QCM)

One person sees the patient and everyone else reads about it. Compliance requires complete documentation to illustrate the patient's history. 

We specialize in:

Recovery and Appeals

Our appeals specialists have an overwhelming success rate for payment of previously denied claims from all Medicare contractors.

Learn more about CMS' Targeted Probe and Educate (TPE) campaign.

QIRT specialists have:

  • Completed thousands of Additional Development Requests (ADRs) in home health care and hospice.
  • Filed thousands of appeals under the current Benefits Improvement and Protection Act (BIPA) system.
  • Had thousands of claims resolved at the administrative law judge (ALJ) level. Our appeals specialists have prepared and/or represented providers under Third-Party Liability (TPL), Zone Program Integrity (ZPIC), UPICs, Benefit Integrity, and Recovery Audit Contract (RAC) reviews.

Unrivaled Knowledge

QIRT recovery and appeals experts apply knowledge of Medicare, Medicaid, and other payer rules and regulations to your clinical document. This knowledge of regulations is applied to documentation to achieve a more favorable outcome than if there were no clear goal in mind. The QIRT team has extensive experience with administrative law judges across the country, where the most favorable overturn rates occur. This is coupled with extensive knowledge of rules and regulations so that denials are handled quickly and with a wealth of expertise. 

Review Choice Demonstration (RCD) 

QIRT has formed a highly trained and credentialed Review Choice Demonstration (RCD) Team. This team is specifically trained to review the documentation in the patient medical record related to CMS' requirements.

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, submitted timely, and remove this additional burden from agency staff - allowing them to spend their efforts caring for their patients and not shuffling paperwork. Learn more....

About Our Lead Expert

Joe Osentoski, BAS, RN-BC, is Reimbursement Recovery & Appeals Director, based in QIRT’s Troy, Michigan office. 

Joe's specialties: 

  • Additional documentation request (ADR) appeals 
  • Extensive experience with multiple Medicare audits (ZPICs, UPICs, SCIO), pre-pay probes, compliance audits, and targeted medical reviews. 

Joe has completed over 5,000 ADRs in home care and hospice, filed thousands of appeals and has had several thousand claims resolved at the ALJ level. Impressively, Joe has been lauded by retired US Administrative Law Judge Robert Soltis in his book, How to Handle Your Medicare Hearing: 

“Mr. Osentoski was one of the first non-attorney representatives to appear before me when I was an ALJ, and he stands head and shoulders above every other non-attorney representative. Mr. Osentoski…knows home health law, and prepares thoroughly. His credibility is beyond reproach.”

Most recently, QIRT is proud to boast that Joe is the published author of Home Health ADR &Appeals Answers, First Edition, available through DecisionHealth. Buy today and use discount code ADR20 to receive 20% off your purchase. 

Image of a book titled Home Health ADR & Appeals Answers, First Edition and a coupon code for 20% off, use ADR20

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

  • Managing Your Bottom-line in an Ever-changing Regulatory Environment Learn More

    Tuesday, October 23, 2018


  • QIRT Introduces New RCD Task Tool and Review Choice Demonstration Team in Response to CMS’ Revision of Pre-Claim Review Learn More

    Tuesday, October 16, 2018


  • QIRT Welcomes Giovanni Pagano, Director of Business Development Learn More

    Tuesday, September 11, 2018


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