Increased Denial of Payment
The "Peace of Mind" SMART offers
The Centers for Medicare & Medicaid Services (CMS) is advancing its oversight to combat healthcare fraud by implementing a proactive "detect and deploy" strategy. This initiative focuses on identifying fraud in real-time, targeting high-risk indicators such as abnormally high live discharge rates and rapid re-enrollments. The recent takedown in LA County serves as a template for future enforcement actions across the U.S. AI tools are now integral in scanning billing data for suspicious patterns. Stay informed on the evolving landscape of healthcare compliance.
Compliance isn't just a requirement—it’s your safety net.
Education-Backed Audits: Get monthly trending data paired with staff education to ensure continuous growth.
Proactive Improvement: We design and implement PIPs that address root causes, not just symptoms.
Quality Excellence: Targeted strategies to improve scores and satisfy patients and families.
Financial Protection: We optimize your Total Performance Score and prepare your team for rigorous medical reviews.