Polaris Group
Consulting Services & Solutions
Infection Control Services
Patient-Driven Payment Model (PDPM) Readiness Services
Medicare Consulting
   - Medicare Support Services
   - Certification Support
   - Utilization Benchmarking
Nursing Consulting
Therapy Consulting
Financial Consulting
OBRA Mock Survey
Revenue Cycle Acceleration
Apollo RM: Risk Management
RAC Audit
Interim MDS
Permanent Recruitment Services
Interim Placement Services
Cost Report Services
False Claim Risk Assessment
Corporate Compliance Consulting
Independent Review Organization (IRO)
Assisted Living Facility Consulting
Additional Services
Call us at 1-800-275-6252
Medicare Compliance & PDPM Support Services

Medicare Compliance Operations Assessment. The Polaris Group's Medicare Compliance Operations Assessment provides you with a tool to evaluate key systems organization-wide that could impact Medicare compliance and related revenue. Polaris Group consultants will evaluate your systems related to nursing, MDS, case management, therapy, billing, and ancillary vendor contracts; identify opportunities to improve revenue, decrease cost, and reduce compliance risk for denials; and provide detailed report with Risk Scores and recommendations.

Medicare & PDPM MDS Accuracy Audits provided onsite and offsite to ensure accurate revenue and compliance with Medicare.

   Clinical Systems Review
  Unplanned Hospital Admissions Review
  Therapy Program Review
  Billing Practices Review
  Ancillary Vendor Performance Review
Clinical Systems Review & Training
  • Onsite or Offsite Medicare and PDPM MDS accuracy check
  • PDPM Training
  • ICD-10 Training
  • GG Coding Training
  • Compliance with Medicare rules related to MDS timing, Interim Payment Assessment, and Interrupted Stay
  • MDS management to obtain accurate PDPM reimbursement
  • Compliance with Medicare eligibility and continued stay requirements
  • Compliance with physician certification and notification of non-coverage requirements
  • Audit the quality and consistency of skilled nursing documentation to support a continued stay
  • Communication and case management systems with therapy and billing
  • Restorative nursing services support of Part A and B
  • Quality assurance activities related to requirements

Unplanned Hospital Admissions Review

Length of Stay and Unnecessary Hospital Admissions:
Provide analysis  of discharges to hospitals within 30 days of admission; identify strategies to increase LOS and unnecessary re-admissions; training for nursing staff is included.

Polaris Group will provide offsite or onsite assistance with identifying unplanned hospital re-admissions by:

  • Providing analysis of root cause for transfers back to hospital within 30 days
  • Identifying preventable causes/transfers and create strategic solutions
  • Training nurses to communicate effectively with physicians
  • Improve pre-admission screening process
  • Provide tools to assist with communication and tracking

Offsite or Onsite in-services to staff include:

  • Impact on your LOS
  • Scope of problem
  • Why re-admissions occur
  • Strategies to prevent
  • How to manage change in condition
Therapy Program Review
  • Therapy documentation to support skilled service
  • Therapy compliance with Medicare requirements
  • Therapy productivity
  • Communication and case management systems with nursing
  • Part B services and utilization
Billing Practices Review
  • Billing Revenue Management
  • UB04 accuracy audit
  • Compliance with Medicare regulations
  • ADR and denials management procedures
  • Part B billing
  • Accounts receivable and payable
Ancillary Vendor Performance and Review
  • Vendor contract review
  • Evaluate price strategies and contract terms with primary focus on pharmacy, therapy, laboratory, radiology, medical supplies/DME, respiratory, therapy and ambulance services
  • Audits of vendor compliance with service timeliness, invoicing accuracy, and documented medical necessity to reduce risk of cost overruns in ancillary services
  • Review cost containment strategies
More Medicare services...
  Revenue Cycle Acceleration
  Medicare Certification Support
  Medicare Part A & Part B Utilization Benchmarking
  Solution Center Hotline
  Key Indicator Trend (KIT)
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