On the heels of reform initiatives requiring providers to conduct compliance audits, we created the most efficient and usable compliance audit tool to help our clients benchmark and improve performance. Our compliance services include:

  • Corporate Compliance
  • Mock ZPIC/RAC Audits
  • Independent Review Organization (IRO)
  • Physician and Ancillary Service Review

Proactive Protection of Every Reimbursement Dollar

In today’s healthcare environment of heightened regulatory compliance enforcement, there’s no better time for skilled nursing facilities (SNFs) to conduct a formal reimbursement compliance audit as part of their corporate compliance plan. By outsourcing this function to Zimmet Healthcare (ZHealthcare), a leading healthcare consulting firm with proven results, you’ll ensure uniformity in processes throughout your organization, and gain insight into detailed peer group performance indicators. But what’s more, you’ll get a fact-based, impartial assessment of your facility.
RAS1Here are just a few value points of the ZHealthcare compliance audit:

  • We conduct over 500 Reimbursement Compliance Audits each year throughout the country, specializing in acuity-based/MDS Medicare and Medicaid payment systems.
  • We have created the industry’s most efficient and “usable” compliance audit tool.
  • Our unique, proprietary “Risk Assessment Scale” quantifies highly qualitative measures of reimbursement compliance, including MDS, billing and supporting documentation. This allows your facility managers to clearly understand and measure detailed problem areas by comparing their compliance scores to the peer group of providers, and by benchmarking improvement during subsequent audits.

How the Compliance Audit Works

ZHealthcare Reimbursement Compliance Audit is the perfect solution to Medicare & Medicaid compliance requirements and the process is as easy as 1, 2, 3:

  1. We use the Office of Inspector General’s RAT-STATS statistical software to select the random sample.
  2. Data is gathered onsite, while most of the analysis is performed offsite to limit intrusiveness.
  3. Within a few weeks of our initial visit, you’ll receive a comprehensive, resident-specific report detailing our findings and recommendations.

 

Download the Reimbursement Compliance Audit Services Data Sheet