Compliance Program Policies & Procedures:

BCMS’s compliance program is considered the gold standard in compliance for outpatient therapy providers.  Our compliance program covers all federal regulations mandated by the Department of Health & Human Services (HIPAA, Medicare/Medicaid, Fraud & Abuse, Non-discrimination) and the Department of Labor (OSHA, EEOC, ADA).  Non-regulated guidance, considered high risk areas, is obtained from agencies and independent organizations such as the Centers for Disease Control & Prevention, the National Institute of Standards and Technology (NIST) and the Office of Inspector General. It is fully scribed policies and procedures specific to outpatient therapy providers (PT/OT/) – not an outline or a list, but actual word documents.  Additionally, our program provides all related forms, resources, staff training, and risk mitigation tools to assist in effective implementation.  To customize, you’ll fill out questionnaires that will auto-populate to create your manuals.  We host them in our cloud portal (but you can download as well) and we will automatically update them annually for you.  Here’s a quick  demo video  

Provider Enrollment & Credentialing:

Our Experts have been carrying out credentialing and enrollment activities for over 18 years with great proficiency. Current services include obtaining a National Provider Identification Number (NPI), credentialing with CAQH (Council for Affordable Quality Healthcare) and credentialing by or enrollment into federal programs as well as most state plans.  

Off-Site Clinical & Billing Records Audits, Appeals & Consulting:

The off-site audit (OSA) service is carried out by physical therapists with extensive knowledge about Medicare payment and coverage policy which is the baseline used for its audits and appeals. These services are unique because each aberrant finding is addressed and evaluated from a compliance as well as a risk prospective. Each patient chart is reviewed for compliance with Medicare’s Benefit Policy Manual, Claim Processing Manual and Program Integrity Manual and commercial payer provider policies, if audited. Clients can choose the number of charts audited as well as the frequency. They may elect to have an Executive Report carried out telephonically, a copy of each chart audit and an individual scorecard for each provider audited.

On-Site Facility Surveys and Audits:

This service provides a comprehensive review of clinical operations, including Human Resources, HIPAA, OSHA, ADA, OCR and documentation and billing from a regulatory perspective. Each component reviewed is addressed in an Executive Report Session as well as in a written Survey Report which includes, as necessary: prioritization of corrective actions and support resources for developing a Corrective Action Plan.

On Site or Remote Security Risk Analysis:

This product line focuses on HIPAA’s Security Rule requirement of conducting a security risk analysis based on required and addressable standards. A detailed report of findings and recommended action, as needed, is provided orally and in written form.

Seriously Important Practice Alerts (SIPA):

Our e-newsletter pledges to provide important information; no advertisement, no fillers and nothing that can’t be substantiated.