Reimbursement

Pathway Health’s Reimbursement Services can ensure your program is accurate and optimizing reimbursement, while maintaining compliance. We provide reimbursement consultation to assist organizations in mitigating risk and identifying areas for performance improvement. Optimization of reimbursement and matching resource utilization to resident acuity is an important part of improving financial performance for health care organizations. Assisting providers in their ability to improve financial and quality performance in the complex reimbursement environment is our passion.

Reimbursement services performed on-site or off-site include:

Assessment to review for accuracy, proficiency and risk

  • RAC/ZPIC Vulnerability Assessment

Comprehensive Assessment

  • MDS/RAI Process Improvement
  • Medicare Process Improvement
  • ADL Process Improvement
  • CAAs and Care Planning
  • Billing and Revenue Cycle Improvement

Reimbursement Training and Education

  • MDS Basics
  • Medicare
  • AANAC Certification course
  • Coding and Scheduling
  • Billing and Revenue Cycle
  • Customized Training for facility leaders, clinicians, MDS team and billing staff
  • Customized  eLearning and Webinars

ICD-9 to ICD-10 Transition

  • Transition Planning
  • Training and Implementation

Restorative Program

  • Program design and implementation
  • ADL tracking, improvement and training

Audit Response

  • Additional Development Request assistance
  • Medical review assistance
  • ZPIC/RAC response
  • OIG Response

National Initiatives

  • Care Transitions (ACO, safe transfer, advanced care planning)
  • Hospital Readmission Reduction
  • ICD 9 to ICD 10 Transition

Ensure your staff has the reimbursement expertise necessary to meet the changing health care environment. For more information, fill out the Contact Us form or call us at 877.777.5463 to speak with our Director of Consulting Services.