MEDICAL REVIEW: Combat Continuous Care Scrutiny With 6 Steps

Why This Topic Matters

Hospices face financial and compliance risk when continuous care is billed, documented, or supported incorrectly. The article highlights practical areas that can affect claim denial, survey findings, and medical review outcomes.

Article Sections

1. Watch for red flags that could suggest over-utilization

   Introduces the compliance concerns surrounding continuous care in hospice settings and frames the article’s focus on utilization and review risks.

2. Six steps to address continuous care scrutiny

   Presents a structured set of broad best-practice areas for hospice organizations to strengthen compliance and audit preparedness.

3. Bill correctly

   Covers general billing compliance considerations tied to continuous care and the importance of understanding program requirements.

4. Individualize care plans

   Discusses the need for patient-specific planning rather than standardized approaches in hospice care management.

5. Document, document, document

   Emphasizes the importance of thorough and ongoing documentation to support continuous care claims and review activity.

6. Tailor ADR responses

   Addresses how providers can organize and present supporting materials when responding to medical record review requests.

7. Beware underutilization

   Notes that compliance risk can also arise when continuous care is not considered or used appropriately in patient care settings.

8. Educate staff

   Highlights internal policy review and staff education as part of maintaining consistent hospice compliance practices.