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Proactive Services

Preparation and Protection

 

Our proactive services are structured to prepare and protect your business from risk. At The van Halem Group, we have developed a menu of proactive services that will accommodate your business needs regardless of your size or the services you offer. Our goal is to improve efficiency and improve compliance within your business, and we offer you the tools to meet that goal. These services are designed to augment your own compliance activities and assure that all the elements of an effective compliance program are integrated into your daily activities. We want you to focus on what is important, caring for your patients, and let The van Halem Group take care of the rest!

On-Site Compliance Assessments

Expert staff from vHG are available to come on-site to your location and conduct an assessment of your organization. Items assessed would include, but are not limited to:

 
  • Effectiveness of your current compliance program
  • Compliance with program requirements
  • Policies and procedures
  • Intake
  • Documentation processes
  • Billing
  • Sales and Marketing
 

On-site assessments are performed at a daily rate per consultant, plus reasonable travel expenses, and include an Assessment Report that outlines vulnerabilities, risk areas and best practices along with recommendations.

 
 

Monthly Compliance Packages

 

The Office of Inspector General (OIG) requires providers submitting claims to the Medicare program to have a Compliance Program that meets government expectations and has indicated that not doing so in today’s environment is considered negligent. We have extensive experience in providing services to augment or enhance your existing compliance program so that it meets these requirements. These services are designed to assist your compliance officer in integrating each of the required elements of an effective compliance program. We have developed four package levels, bronze to platinum, providing you the option to choose the one that best fits your needs.  Each monthly package includes the following:

  • User licenses for custom online compliance training with management reporting and tracking
  • Quarterly random sample generation
  • Technical and Clinical review to ensure compliance in coding, billing and medical necessity
  • Quarterly Audit Reports per location with benchmarking  
  • Compliance consultations, corrective action plans, and quarterly education following audits
  • Anonymous Compliance Hotline (Telephone and Web-based) for all employees
  • Compliance literature for all locations
  • Quarterly compliance newsletter
  • Discounted rates on reactive services

Monthly Compliance Package pricing varies dependent on the level chosen, number of locations and employees. 

 

Clinical PreScreen Reviews

We provide pre-screen audits of claims prior to submission to ensure your claims are complete and accurate.  Submitting complete and accurate claims will reduce audits and appeals, which saves you time and money and reduces your risks for violations of healthcare regulations and laws. Our expert clinical staff will review the documentation to determine all requirements have been met prior to dispensing the products to assure compliance with all requirements. This reduces unnecessary risk of claim denials or overpayments. Our reviews can also be used as educational tools with referral sources and transfers some of the burden of being a “difficult provider” to us. 

Our Clinical Prescreens are per file fees and based upon complexity.  

 

Proactive Desk Audit

If a monthly compliance package does not meet your needs, we can also perform a one-time desk audit. Our staff will assist in identifying a universe of claims, choose a random sample, and request specific documentation. The entire process is accomplished electronically without need for an on-site visit. Once a comprehensive clinical, coding, and technical review is performed, an Executive Summary is drafted and provided. Once reviewed, a follow-up education and training session is scheduled with appropriate staff members.  

We offer several pricing options based on the number of claims audited.

 

Education and Training

Our expert consultants are available to come on-site to your location to provide education and training on a wide array of issues dependent on your specific needs. On-site education and training is performed at a daily rate per consultant plus reasonable travel expenses.

We are also available to conduct online webinar training for your staff on these same issues.  Webinar costs are assessed on a per hour basis.

 

Medical Record Collection

Our Medical Records team is available to obtain records or attestations for clients that need that assistance.

Pricing is determined on a per request or monthly retainer depending on volume.