Prepayment Reviews of Behavior Health Agency Claims are Increasing. Are the healthcare services you are currently providing compliant with applicable coverage, documentation and medical necessity requirements?
Have you carefully reviewed your current caseload to ensure that each patient does, in fact, meet the admissions criteria.” Do you have an effective Compliance Plan in place to assist you with your efforts? Now, more than ever before, it is essential that you understand and follow the rules. Compliance is not optional — it is required of all participating providers.