Healthcare Provider Solutions

CLINICAL SERVICES

Clinical Compliance Consulting for Home Care & Hospice Agencies

HPS offers several clinical and operations consulting services that will minimize risk, maximize productivity, and optimize your agency’s revenue cycle and overall operations.

Mock Surveys

Whether Home Care or Hospice, whether initial certification survey or recertification survey, agencies are in the mode of survey preparation on an ongoing basis. HPS stands ready to assist in all aspects of survey readiness with highly experienced clinical consultants.

Mock surveys include, but are not limited to the following:

  • Review Home Care or Hospice Organization Structure
  • Review Agency Policies & Procedures Manual
  • Evaluate Agency Personnel Files, Including Independent Contractors
  • Attend and Evaluate IDG Meetings (Hospice)
  • Review Continuing Education Program
  • Review Infection Control Program
  • Review Performance Improvement Program
  • Review Emergency Preparedness Program
  • Review QAPI Program

In addition to the above procedures, HPS will also clinically review a sample of patient charts to identify compliance and regulatory documentation issues and perform home visits with a sample of clinicians.

Empower Your Staff with Our Team of Experienced Clinicians

Healthcare Provider Solutions CEO Melinda A. Gaboury shares a look at our primary goals when supporting home care and hospice agencies on the clinical level.

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Clinical Compliance Chart Reviews

All Medicare certified home care and hospice agencies are required to conduct quarterly clinical compliance chart reviews per the Conditions of Participation (CoPs). HPS is prepared to help you meet this requirement. HPS can perform these reviews on a quarterly, semi-annually, annually or on an as needed basis. These reviews can be performed on-site or remotely.

The charts will be reviewed for compliance with frequency and duration of orders, appropriately documented and signed physician orders prior to billing, OASIS submission & acceptance prior to billing, etc. You will also be provided a full Error Summary.

Our review staff will be available for one-on-one consultations with clinical staff that are struggling with home care or hospice documentation. All chart reviews will be conducted by qualified consultants with the clinical and billing expertise necessary to identify compliance and regulatory issues to maintain seamless documentation

Quality Assurance/Performance Insect (QAPI)

Quality Assurance and Performance Improvement (QAPI) – process dedicated to achieving positive results for your agency, individual employees and patients. The process helps identify factors that contribute to a desired performance or outcome and how those factors can be maintained, improved or strengthened across the spectrum of care.

Home health agencies and Hospices employ a variety of methods in monitoring quality performance and improvement in outcomes including, continuous quality improvement, quality assurance, quality management, process improvement and positive outcome-based quality measures.

Home Health and Hospice agencies must develop, implement, evaluate and maintain an effective, ongoing, agency wide, data driven program and be able to demonstrate to CMS its operations by maintaining documentary evidence of its QAPI program.

HPS can assist with ensuring you have an effective QAPI program in place to improve patient care outcomes and agency performance while meeting regulatory compliance with the Medicare Conditions of Participation and standards for the QAPI program requirements.

  • Review current or assist in developing QAPI program for regulatory compliance and provide recommendations.
  • Develop agency annual QAPI plan to be approved by the governing body by identifying agency specific quality indicators for data collection and analysis including clinical record reviews.
  • Assist with developing and implementing Performance Improvement Projects (PIPs) to ensure proper data is being collected with focus on High Risk, High Volume or Problem prone areas.
  • Complete quarterly chart reviews to be included in the data collection and analysis used to identify trends for opportunities for quality improvement.

Upcoming Events

21 Oct

Hospice Billing Series: Part 2 – Details of Medicare Claims Processing

October 21 @ 2:00 pm - 3:30 pm EDT REGISTER Speaker: Melinda A. Gaboury, CEO

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Why Agencies Choose HPS

“Melinda, Mark, and their staff are professional, honest, responsive, and true thought leaders. Their expertise enabled our agency to realize significant cash flow improvements and clinically focused operational advancements.”

Consulting Client

“It’s so reassuring to have experts managing our accounts and know that it’s being done ethically and ‘by the book.’ Our days in AR have never been so low. “

Home Care Agency Director

“HPS helped me reduce my aging by $140,601. Thank you sounds kind of hollow for such a feat, so I will capitalize it: THANK YOU!”

Colorado Hospice Provider

HPS IS Proud to Be Affiliated With Home Care & Hospice Associations

Schedule a Meeting with a Healthcare
Provider Solutions Professional

MELINDA A. GABOURY

Chief Executive Officer

DEDRA J. BRIGGS

Clinical Project Manager

LESLIE HEAGY

Clinical Service Manager