At Dominion Professional Associates, we offer quality management services which will help lead to better quality outcomes and successful reimbursements, when available. Our services include:
- Mock Audits – We conduct mock audits just like the actual ones conducted by surveyors from CMS (Centers for Medicare and Medicaid Services). Our surveyors will observe your organization’s processes, prepare your staff for the actual surveys, and develop plans that will improve quality.
- Chart Audit/Clinical Record Review – These audits are conducted to ensure that the organization is compliant with the relevant regulations and the appropriate reimbursement.
- Denial Utilization Review – Reimbursement denials can happen even if you have a well-trained staff. In case of a denial, our team will appeal all unpaid claims after gathering all pertinent information and analysis. We take this task off your staff’s shoulders. We will also develop strategies that will help minimize the likelihood of reimbursement denials in the future.
- Case Management – Our team gathers data through observations and interviews to look for improvement opportunities concerning all processes involved in a client’s operations.
- Prepayment Review and Prep – Prepayment reviews are often conducted by the CMS for verification of payment billings to their programs. We can help your staff prepare for the review by preparing documentation for a successful prepayment reimbursement. We will also strive hard to meet thresholds of 80% approval rate.
Our team of experienced consultants and surveyors will be teaming up with you, evaluating your processes, identifying opportunities, and addressing them. Through our expertise, we can help your organization achieve the desired outcomes concerning quality management.