Strengthening Your First Line of Defense: Leadership Strategies for Claims Review in Today’s Audit Environment

Insights from Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, IPCO, QCP, ICC – Director of Reimbursement and Education, Pathway Health In today’s regulatory environment, nursing home leaders cannot afford to take a passive approach to claims review. CMS has intensified external audit activity—from Targeted Probe and Educate (TPE) reviews to RAC audits—and organizations are seeing significant...