skip to Main Content

IRF Audit Webinar (Part 2)

Presenter: Darlene D’Altorio-Jones, Senior Consultant

(Part 2 of our IRF Audit Process Series) Walk through the critical steps you must take the moment an audit leads to costly denials or internal concerns at your facility. In Part 1 of this series, we worked through how to audit your medical records; by viewing part two, you will gain a simple approach to analyze results, establish a program for continuous improvement and defend against any denials you may have already received.

What You Will Learn:

  • Gain the tools and skills to self-audit and take corrective action to meet FI/MAC or RAC audit expectations;
  • Use a Likert Scale to focus improvement and create action plans;
  • Write rebuttals to support necessary documentation that meet the criteria outlined in IRF regulations;
  • Confidently respond to denials, rather than hiring costly consultants;
  • Take proactive steps to avoid audit problems, rather than simply react; this exercise will assist you in managing this expectation.

We have also provided a template to drive improved performance, and a rebuttal format that enables you to tag the areas of the chart pertinent to demonstrating medical necessity for IRF level of care.

IRF 2010 Regulations for Medicare Part A were not optional guidelines. Audits of charting with technical deficiencies can trigger full denial. If you are not auditing process, completion and appropriate information and timelines to expectations, you may be at risk for substantial losses. If in preponderance you are deficient, you may even risk licensure to operate and be paid under IRF- PPS. Protect your organization – watch this essential webinar recording now!

Who would benefit?

Compliance Managers, Directors, Nursing/Therapy Managers, Rehab Physicians and Quality Improvement staff will benefit from watching.

Presenter bios:

As a Physical Therapist with an MBA in Healthcare Management, Darlene is a Senior Consultant at Mediware, Darlene’s focus is to assist clients to utilize electronic documentation to its utmost potential in compliance, outcomes, revenue and efficiency. Working in rehabilitation medicine for more than 30 years, Darlene spent 12 years as a Director of Rehabilitation, with oversight of three post acute care service lines: acute rehabilitation, skilled and outpatient hospital-based services. She was instrumental in maintaining clinical adherence to IRF Federal Regulations and leading CARF and Joint Commission standards of practice. In addition, Darlene’s experience includes Quality Improvement Chair, Lean Healthcare training and serves as an active member of the Board of Directors for the Ohio Association of Rehabilitation. Darlene develops course content and blogs on federal guidelines for post acute admissions, level of care medical necessity, documentation, IRFPAI tool completion, and rapid throughput review for management process improvement.

Back to top