MedManagement provides comprehensive solutions that address the regulatory burdens experienced by Inpatient Rehab Facilities (IRFs) through real-time, concurrent support from Physician Advisors who can help navigate the medical necessity requirements, including medical necessity consulting, continued stay management, document consultation, RAC audits and RAC appeals.
Medical Necessity Consulting
Since what inpatient rehab facilities are paid is so dependent on the medical necessity of the services rendered, it is important to verify that each patient’s medical record has adequate documentation to support the medical necessity of the services that are submitted for payment. The clinical team of Physician Advisors at MedManagement is specially trained to review Medicare and Medicaid admissions and evaluate whether the patients at your inpatient rehab facility are receiving appropriate inpatient rehab services appropriate as defined by the Centers for Medicare and Medicaid Services (CMS). Our level of care consulting services will not only improve your facility’s documentation but also support a strong compliance program.
All inpatient rehab facilities should strive to thoroughly document each patient's case so that the correct reimbursement is received, unfortunately in many busy medical settings such documentation is often understated, non-specific, or missing. Our Physician Advisors serve as an excellent resource to inpatient rehab facilities to ensure that medical records are a true reflection of the intensity of the services provided, and facilities receive the appropriate reimbursement.
RAC Audits/AppealsTo mitigate RAC risk, inpatient rehab facilities should develop a strategy that includes the creation of policies and procedures for proper clinical documentation. This ensures you receive the appropriate reimbursement for services and can also assist with RAC appeals if you are audited. MedManagement’s proactive approach to solid clinical documentation helps lessen RAC risk to protect your hospital from both financial and legal difficulties.