Chart Audits

CMS and the OIG are targeting inpatient rehabilitation. In CMS’s May 2004 rule, the requirement states that physician and clinical staff documentation must support medical necessity and rehab necessity for admission to inpatient rehab. The OIG has already started review of inpatient rehab facilities in the Northeast; make sure you are ready if they come to your facility.

FHA has worked with over 350 rehab program nationwide. Our team’s track record includes review of over 470 inpatient rehab charts, consulting assistance to intermediaries and successful appeal of denials. Staffed by a team of physicians, therapists and nurses, we provide:

• Chart review services that assess documentation to see if it supports the appropriateness of the rehab admission based on CMS’s rules.
• Training of documentation to support the PAI rating.
• Immediate feedback to management on critical issues.
• Physician-to-physician education for meeting medical and rehab necessity requirements.
• An action plan to address deficits.
• An elective follow-up chart review to gauge progress or setback.
• Assistance with denied appeals.