Weatherbee's executive and consulting teams assist hospices with acquisitional and organic growth, rightsizing and reorganizing, strategies for successful management and performance, qui tam and other investigations, and a host of compliance and improvement-oriented endeavors.
Contact us to explore how Weatherbee can help your hospice.
ADRs & Appeals
Weatherbee assists hospices with Additional Development Request (ADR) submissions, appeals, and education to identify and mitigate risk exposure.
Weatherbee works with hospices that have been targeted by the Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG) regarding their high percentage of long stay and/or facility-based patients; those in receipt of probe edits from Medicare Administrative Contractors (MACs); and, those hospices under the review of a Zone Program Integrity Contractor (ZPIC), Recovery Auditor (RA), and other organizations investigating payment-related issues.
When seeking to acquire an established hospice program, conducting pre- and post-acquisition clinical due diligence is a crucial step in evaluating the overall feasibility and advisability of the acquisition as well as its subsequent success.
Weatherbee Resources can serve as your Independent Review Organization (IRO) for the purpose of reviewing all the data elements that substantiate your hospice's compliance with the Corporate Integrity Agreement (CIA) and evaluating the eligibility of patients to elect the Medicare/Medicaid Hospice Benefit.
Weatherbee provides interim management and coaching to assist hospices through periods of transition, filling vacant leadership positions, and providing coaching to new leaders ascending to senior positions in your organization.
Any hospice can be selected for an investigation or audit. An investigation of any kind is disruptive to the organization, may damage your reputation in the community and could seriously threaten the financial viability of the program.
Clinical Record Audits
How good is your team's documentation? Do you have systems and processes in place to give you confidence that every bill submitted will result in payment?
Periodic external reviews of your documentation can identify potential issues before they become major problems.
Weatherbee offers advisory services for hospice Medical Directors and physicians, provided by well-qualified physician experts.
The Improving Medicare Post-Acute Care Transformation Act (IMPACT) Act requires that the Centers for Medicare and Medicaid Services (CMS) ensure that each Medicare-certified hospice agency undergo a survey at least once every 36 months for the next 10 years. This requirement became effective in April 2015; however, many hospices have gone 5 or more years since their last survey and are uncertain what the outcome will be for their next CMS/State survey.
The list of compliance and fiscal challenges facing hospices is beyond daunting. Hospices that had previously experienced a growing census and healthy bottom line are, at best, watching their operating margins shrink.
Weatherbee's newest consulting services, offered in conjunction with the kb group, focus on helping to grow your organization and increase your bottom line.
A critical component of a hospice's corporate compliance program is a mechanism for staff to report potential fraud and abuse. An effective reporting mechanism allows staff to raise concerns without fear of retaliation.
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes your hospice’s Medicare claims in target areas that may be at risk for improper Medicare payments, allowing hospices to identify specific areas in need of focused attention.