Our Expertise
Regulatory
Compliance
Our expertise is interpreting and integrating regulatory requirements into your day-to-day operations. The ROC team will assess your processes, perform audits, and work with you to determine optimal, practical solutions supportive of regulatory requirements. In addition, we have direct experience in the development, implementation, and evaluation of integrated compliance programs that meet OIG guidance documents and specific regulatory compliance risks.
Clinical
Documentation
ROC will build on your existing foundation or help build new documentation templates that will result in greater coding specificity, improved case mix, appropriate reimbursement and act as a defense against denials. Our experts can also assist in EMR development that assures your documentation fully and accurately reflects the severity of illness, complexity of care, and meets all requlatory requirements.
Performance
Improvement
We focus on operational and clinical processes in addition to resource optimization to improve the overall outcomes and effectiveness of the healthcare enterprise. Our collaborative approach to patient-centric performance improvement is designed to uncover opportunities across the care continuum.
Licensure, Certification and Accreditation
Let our experts facilitate your State and Federal licensure requirements and your organization’s preparation and maintenance of Accreditation Standards (i.e.,The Joint Commission and Medicare “Conditions of Participation”). We also can assist with 855 applications, preparing for Medicare validation surveys and providing guidance in the event of a Medicare decertification action.
Denial
Management
We assist healthcare providers in responding to Government (i.e., RACs, MACs, CERTs, OIG, ZPICs, CMS) and Commercial denials. Our goal is preventing denials and recoupment from occurring by educating and equipping your staff with resources to help prevent future denials as well as simplify your appeal process in order to save time and resources.
Due
Diligence
Mergers, acquisitions and partnerships are commonplace in today's healthcare market.
By analyzing the major elements of a targeted entity's business we can provide you with the important facts prior to a business transaction, acquisition or contract. Our team of clinical and operational experts, will conduct a comprehensive assessment of critical aspects of the business. We focus on performance history and assess any regulatory risks.