UltraCare Healthcare, LLC

Medicare Compliance:

UltraCare will provide quarterly visits to each SNF community to evaluate the degree to which best practices under Medicare PPS have been implemented in the areas of nursing, therapy, billing and ancillary vendor contracts.

UltraCare will perform the following:

    Nursing Review
  • MDS accuracy check to RUG items
  • Compliance with Medicare rules to related to MDS timing, reason for assessment, use of grace days and OMRAs.
  • MDS management to obtain accurate RUG 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 continued stay.
  • Communication and Case Management systems with therapy and billing.
    Therapy Review
  • Therapy documentation to support skilled service.
  • Therapy compliance with Medicare requirements.
  • Therapy minute management to achieve accurate RUGs.
  • Communication and Case Management systems with nursing.
  • Part B services and utilizations.
    Medicare Statistical Benchmark Report
  • Length of stay
  • Length of stay by primary diagnosis
  • RUG category distribution
    Billing Practices Review
  • Billing Office Operations assessment
  • UB04 accuracy
  • ADR and denials management procedures
  • Part B billing
  • Accounts receivable and payable
    Ancillary Vendor Review
  • Vendor contract review
  • Evaluate price strategies and terms of contract.
  • Audits of vendor compliance with service timeliness and invoicing accuracy.
  • Review cost containment strategies.

Medicare Billing | Medicare Certification