Proactive Services Include… 

Proactive offers confidential Medical Review solutions, working directly with post acute care service providers or through legal counsel. With the onset of Healthcare Reform and the Patient Protection and Affordable Care Act (PPACA,) efforts to reduce fraud and abuse of the Medicare system have escalated through automated and complex review; however, many upstanding providers have been impacted by this increased level of review despite their effective care and ethical billing practices.

When good providers undergo Medical Review, the administrative burden and financial implications can be significant. Proactive partners with clients to facilitate advanced documentation skills, ensure compliance with regulatory standards, and foster successful outcomes under the scrutiny of Medical Review. We specialize in Medicare Medical Review and can help you prepare for and respond effectively to review types outlined in the OIG workplan including RAC, ZPIC, CERT, FI/MAC reviews, as well as private insurance reviews. Our team of specialists includes expert geriatric therapist, nurse, and billing consultants. With therapist consultants on staff, we are uniquely positioned to assist long term care facility providers as well as outpatient therapy clinics through Medical Review involving rehabilitation services. Let us put our experience in successfully managing thousands of ADRs and Medicare appeals to work for you!