Bloomingdale Consulting Group, Inc
The Rehab Compliance Experts...
Bloomingdale Consulting Group, Inc is a rehab consulting firm that provides consulting and training services targeted to the therapy clinics and the rehab professional. The regulatory environment of Medicare, the ever-changing environment of managed care, and the constant need to develop and implement effective marketing strategies are challenges faced by most rehab providers and therapy clinics on a daily basis. Bloomingdale Consulting Group will assist you with these challenges and provide targeted consulting expertise to enable you to meet these challenges.
Don't Get Caught in the RAC Trap- Demand Letters Are in the Mail
Rehab providers are reporting receipt of Demand Letters in Region C for the billing of untimed codes in units greater than 1 (one). The Recovery Audit Contractors for both Region C (Connolly Healthcare) Region D (HealthDataInsights) and Region B (CGI) posted the CMS approved issue of Untimed Codes for automated review beginning in August. Further tips on manging the issue of untimed codes should help you gain further insight into the issue of untimed codes and what you can do to prepare yourself..
When you select Bloomingdale Consulting Group for your rehab project, you are working with credentialed professionals with extensive experience in rehabilitation. We have provided a sampling below of the various types of projects in which we are involved. Call (888) 999-0275 to discuss your potential project.
Case Study Samples
Managed Care Negotiation Strategy Development - A hosptial outpatient therapy system was renewing a capitated managed care contract with a physician IPA where the hospital was losing money. They requested financial analysis of the past two years performance under the contract and recommendations for establishing a negotiating position that would bring profitability to the contract. A completed financial analysis was done, as well as a selected review of patients clinical and financial records. We assisted the provider in developing a negotiating strategy that was based on quality care indicators, patient education, and restructured a reimbursement paradigm for outlier cases that was accepted by the IPA.
Compliance Guidance for OIG Site Visit- A provider under a CIA (Corporate Integrity Agreement) with the Office of the Inspector General requested onsite assistance during the OIG's site review of the facility. The provider felt that an outside set of expert eyes would provide valuable insight duing the two day visit. The OIG positively noted the use of a consultant in both their exit interveiw and subsequent follow-up report.
Managed Care Contract Review - A group therapy practice requested review of managed care contracts where the renewal agreement terms changed from the original signed contract. We reviewed the contract, pointed out inconsistencies, lack of explanation of contract terms, and recommended the exclusion of certain contract terms automatically extending discounted pricing to future products. The managed care plan accepted the terms, and the provider was saved from automatically discounting a higher paying book of business when the managed care plan brought this product to market.
Compliance Program Development - A small private practice asked for assistance in developing policies and procedures to be compliant with Medicare. We provided a template policy and procedure manual that we assisted the provider in customizing and updating during several years of rapid growth consistent with the OIG Compliance Guidance for Physicians and Small Practices.
Medicare Documentation Training - A hospital outpatient department requested a Medicare documentation training for therapy staff based upon the Local Coverage Determination of their new fiscal intermediary. Seasoned therapy staff wanted to ensure best practices in the use of procedure and diagnosis codes, and wanted recommendations on documentation format and efficiency.
Monitoring and Auditing - A medium sized thearpy network, with clinics in several states, requested development of an annual monitoring and auditng plan that took into account not only Medicare documentation requirements, but the differences in the local coverage determiniations for the different Medicare carriers they billed. Based upon findings from these activities they asked us to develop a training program for clinical staff, billing staff and front office staff to ensure full compliance.
Mandated Compliance Training Under Correctice Action Plan - A small rehab agency was cited by their fiscal intermediary for not complying with intermediary requests. The corrective action plan called for specific training to be conducted by an outside rehab expert to include documentation requirements and full compliance with Rehab Agency Conditions of Participation.
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