Clinical Solutions
Clinical Programs Clinical Reimbursement Compliance & Education Outcome Measures & PDPMClinical Programs
Preferred Therapy Solutions will provide resources to enhance or develop clinical programs designed to meet the needs of your residents. The keys to success in a value-based system begins and ends with patient outcomes. The ability of providers to implement cost-effective clinical services, deliver outstanding patient outcomes, meet/exceed customer and referral source expectations and accurate reporting will be paramount. Our programs are designed to seamlessly integrate with nursing and the entire interdisciplinary team to advance care and outcomes. Our leadership team and yours will gather to assess clinical competency, communication, care management and care delivery systems to ensure clinical programs are appropriately implemented and tracked for success. Learn More.
Clinical Reimbursement Specialist
Our nursing and therapy teams will partner with the rehab staff and nursing teams on PDPM. Preferred Therapy Solutions involvement will enhance data capture and establish opportunities to improve financial and clinical success.
Our CRS team will meet and implement a strategic plan to development and ensure effective systems for data capture, collaborate on policy development, and design custom programs that are unique for each facility. Specifically, we will analyze and assist with the following:
- ICD-10 diagnosis assignment
- Clinical conditions category assignment oversight and collection
- Case mix index training
- NTA and nursing utilization and assignment
- MDS Coordinator workflow optimization
- NTA and nursing improvement plan
- Revenue optimization category identification
- Training and education program development
- Skilled nursing/rehab documentation auditing
- Clinical program assessments
- Monthly meeting to review audit results and action plan development
Compliance & Education
A Focused Resource for Operations and Compliance
The PTS Compliance and Education team provides our rehabilitation staff with a systematic, risk-focused approach to managing operations and compliance efforts. We are a focused resource working with facilities appreciating the diverse and complex challenges that skilled nursing facilities must address.
Education & Program Development
By connecting under a common compliance framework, the Regional Leadership Team is able to consolidate data, manage clinical outcomes, and provide our partners with enhanced monitoring tools and quality information for decision-making.
Our therapists have the most up-to-date industry educational resources, tools, and program development applications. The PTS standards in working collaboratively with each facility is our methodical approach in meeting the individualized needs of our patients, partners, and employees.
Appeals Process Expertise
Managing the appeals process poses an administrative burden for health care
providers including our skilled nursing facility partners. Preferred Therapy Solutions has expertise and experience to manage the appeals process for our partners. We ensure we have all necessary documentation to write a clear and thorough appeal beginning at the Redetermination level (Level I) and continuing through all five levels of the appeals process, if necessary. Our success rate for Level 1 appeals ranks in the 90th percentile.
What Sets Us Apart
Preferred Therapy Solutions focused internal audit function employs a systematic, consistent, standard-based, disciplined approach to protect against the impact of non- compliance. In addition, to the formal comprehensive audits that occur on a regular basis, audits are also performed as needed or required. We continue to follow up and to monitor each facility’s audit results, ensuring ongoing compliance and assisting our partners in successful survey preparation.
What Sets Us Apart
Outcome Measures & PDPM
Maximizing results and outcomes
Today, more than ever, clinical outcomes will influence the decisions of our partners in care; physicians, hospitals, accountability organizations and most importantly, our patients. One of our fundamental deliverables is our ability to track and monitor the quality of our services through clinical outcomes. As the significance of outcomes becomes increasingly relevant in a value-based healthcare system, our focus on clinical outcomes allows us to ensure our patients get the very best from our clinicians and provide our partners with confidence in our service.
PTS has been preparing for the transition from volume to value for a number of years. We are confident that our collaborative preparation with our partners will lead to success under PDPM. We remain committed to ongoing positive clinical and financial outcomes and welcome the opportunity to demonstrate our commitment to excellence and value. PTS has all of the necessary resources in a highly effective, multi-disciplinary regional team and clinical reimbursement specialists (NURSES, MDS COORDINATORS AND THERAPISTS) prepared to operate successfully in a value-based reimbursement system.
Our clinical reimbursement specialists meet with our partners, monthly, for strategic plan development, auditing, action plan development and implementation protocols. Contact us for an Analysis and Discussion.
