Reach affirmation by achieving and maintaining Review Choice Demonstration compliance
The Review Choice Demonstration (RCD) continues to expand across the country and it is crucial for home health agencies and inpatient rehabilitation facilities to recognize and prepare for the changes it brings. Organizations must ensure their supporting clinical documentation and billing processes are well established in order to meet the Centers for Medicaid & Medicare Services (CMS) requirements. These requirements include accurate and comprehensive patient assessments, evidence of medical necessity, adherence to homebound criteria for home health, and detailed justification of skilled services, all documented in a manner that meets CMS’s stringent standards for quality and accountability.
The Review Choice Demonstration initiative specifically targets home health agencies and inpatient rehabilitation facilities, requiring them to meticulously validate their compliance with CMS standards through rigorous documentation and billing reviews, thereby ensuring the provision of legitimate, necessary healthcare services to Medicare beneficiaries.
RCD Compliance by Practice Type
We provide both pre-claim outsourcing and post-payment additional development request (ADR) services. By conducting thorough documentation reviews including face-to-face, plan of care, homebound status and skilled need, our clinical consultants provide your agency with recommendations and feedback on how you can stay compliant.
McBee services streamline the RCD compliance process for your agency, offering expert guidance through pre-claim reviews and post-payment ADRs to ensure your documentation fully meets CMS requirements, safeguarding your compliance and optimizing your operational efficiency.
We provide proactive audit and education support for facilities that are either in the middle of RCD or or preparing for it. Our team of coding and clinical IRF specialists audit charts in accordance with the strictest interpretation of the Code of Federal Regulations (CFR) and the Medicare Benefit Policy Manual (MBPM), as well as IRF RCD guidelines. The audit results are provided in a summary report with observations and recommendations to help your facility prevent denials and produce positive RCD affirmations.
McBee audit and education services equip your facility with the insights and tools needed to navigate RCD challenges effectively, ensuring your practices align with federal regulations and RCD guidelines to minimize denials and achieve affirmative outcomes.
Request more information about our Review Choice Demonstration services.
The McBee Advantage
McBee’s RCD services team steps in to reduce documentation errors, identify billing inconsistencies and ease your organization’s pain points.
Detailed review of documentation required for RCD submission
In-depth knowledge of CMS regulations and requirements
Clinical consulting group with an average of more than 30 years of experience in documentation compliance
Experience supporting nationwide, regional, and independent organizations with RCD
Resources to Navigate Review Choice Demonstration
Download our complimentary eBook to discover the key strategies for RCD success, including optimizing workflows, implementing quality assurance checks and leveraging comprehensive documentation reviews.
Join Marjorie Mantione, Clinical Consulting Manager at McBee, as she provides an overview of the IRF Review Choice Demonstration (RCD), the process, CMS and Palmetto GBA updates and more.Frequently Asked Questions
The Review Choice Demonstration (RCD) is a program by the Centers for Medicaid & Medicare Services (CMS) aimed at ensuring quality in home health and inpatient rehabilitation facilities. It requires these organizations to demonstrate compliance with CMS requirements through supporting clinical documentation and billing processes.
Home health agencies and inpatient rehabilitation facilities that are either currently under the RCD or preparing for it need to comply. This includes ensuring their documentation and billing processes meet CMS standards.
McBee provides pre-claim outsourcing, post-payment additional development request (ADR) services, proactive audit, and education support tailored to both home health agencies and inpatient rehabilitation facilities to help them comply with RCD requirements.
McBee conducts thorough documentation reviews, including face-to-face evaluations, plan of care assessments, homebound status verification, and skilled need analysis, to provide recommendations and feedback for staying compliant.
McBee offers audit and education support, including chart audits in accordance with CFR and MBPM guidelines and IRF RCD guidelines, providing a summary report with observations and recommendations to prevent denials and achieve positive RCD affirmations.
The McBee Advantage includes reducing documentation errors, identifying billing inconsistencies, and providing in-depth knowledge of CMS regulations, backed by a clinical consulting group with over 30 years of experience in documentation compliance.
Organizations can prepare for RCD by optimizing workflows, implementing quality assurance checks, leveraging comprehensive documentation reviews, and staying updated with CMS and Palmetto GBA updates.
The Review Choice Demonstration significantly impacts billing processes by requiring these organizations to submit their clinical documentation for pre-claim review or face post-payment review, depending on their choice. This ensures that the billing is compliant with CMS requirements, aiming to reduce improper payments and encourage high-quality care.
Critical documentation for RCD compliance includes thorough and accurate face-to-face encounter records, comprehensive plans of care, evidence of homebound status for home health patients, and documentation of skilled needs. For inpatient rehabilitation facilities, detailed chart audits in line with CFR and MBPM guidelines, as well as adherence to IRF-specific RCD guidelines, are essential.
Failing to comply with RCD requirements can lead to claim denials, recoupment of payments, and potential inclusion in future CMS audits. It underscores the importance of thorough documentation and billing accuracy to demonstrate compliance and ensure the provision of necessary and reasonable services covered under Medicare.
