Inpatient Review Services
ACS consultants provide MS-DRG audits as well as review for APR-DRGs. Our team of expert credentialed coding consultants conduct DRG prebill, retrospective, concurrent reviews to promote coding accuracy and documentation adequacy to assure the hospital receives the optimum reimbursement to which they are legally entitled. Follow up education is key and provided at the end of each consultation.
Medical Necessity of Inpatient Admission
Our one-day stay reviews are designed to target the Medicare population. We take time to analyze your facility specific data and PEPPER report to determine areas of risk. Our consultation services include a record review to evaluate compliance with admission screening criteria, adequacy of physician documentation and accuracy of DRG assignment. We customize our education for your hospital leadership, case managers and coders based on our review findings.
ACS consultation for inpatient psychiatric facilities is designed to target the Medicare population whose claims are reimbursed under the Prospective Payment System. Our consultation services include medical record review to evaluate the adequacy of physician documentation, and accuracy of coding to assure optimal DRG reimbursement assignment and capture of CC’s. Education for hospital leadership, psychiatrists, consulting physicians, behavioral health staff, and coders is conducted at the close of our review.
Long Term Acute Care (LTAC) PPS
By law, CMS pays long-term care hospitals under the LTCH Prospective Payment System. These prospective payment systems establish prospectively set rates based on the patient’s diagnosis and the severity of the patient’s medical condition.
We provide audit and educational services to assist LTAC’s achieve accurate and optimal reimbursement through improved documentation by the provider and coding accuracy.
Compliance with Medicare Conditions of Participation for implementing a Swing Bed program is easier than you think! Since 1985, ACS has been assisting hospitals develop the required policies and procedures and conduct staff education so they can be ready for state health department surveys. Follow up compliance audits are available to make sure your program continues to excel.