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Review Choice Demonstration Preparation Services
Objectives
Prepare for 100% review of all Medicare fee-for-service claims through the Review Choice Demonstration (RCD) Identify steps to meet growing IRF-PAI documentation requirements Resolve discrepancies between care rendered and care recorded using careful documentation review
Process
Step 1 — Outcomes data review
- Assess components of the case mix index to determine which financial drivers and quality measures are trailing benchmarks
- Analyze eRehabData reports and historical data
Step 2 — Operational review
- Assess the coding and functional scoring process
- Assess the care delivery and case management process
Step 3 — Records review
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Assess documentation to determine strengths and opportunities due to lack of medical necessity, inaccurate coding of Rehab Impairment Groups, etiologic diagnoses, comorbidities, or inaccurate scoring of QRP and functional measures.
Review Choice Demonstration flyer (pdf)
Deliverables
Extensive education and staff training included with every engagement.
- Data analysis with industry comparisons and trends
- Operational assessment and detailed recommendation for improvement
- Medical necessity assessment and detailed recommendations for improvement
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