PROGRAM Evaluation
RHCs are required to conduct an evaluation of its clinical program every two years. The evaluation may be done by RHC staff or through arrangement with other appropriate professionals.
Healthcare Business Specialists can assist you in completing this process. The program evaluation can be accomplished in about 4 hours of onsite time.
During the program evaluation, we will come onsite and conduct a mock inspection of the facility. While onsite, we will review the policy and procedure manual and any supporting documentation to ensure that the clinic is following its policies. We will also review clinic utilization, CPT code frequency, denials, EOBs, and chargemasters to assess if the clinic is charging, billing, and collecting the proper amounts from patients, insurance companies, Medicare, and Medicaid.
Upon completion of the mock inspection, we will present any findings to the Professional Advisory Group and prepare a comprehensive report for the clinic records.
As part of our report, we will compare your expenses to benchmarks of other rural health clinics in our database of rural health clinic cost reports. This report will help you to determine how efficient your clinic is operating in comparison to other rural health clinics.
MOCK INSPECTION
RHCs are required to conduct an evaluation of its clinical program every two years. The evaluation may be done by RHC staff or through arrangement with other appropriate professionals.
Healthcare Business Specialists also performs mock inspections. If you are due for an unannounced survey and want reassurance that your clinic will pass, we can perform a mock inspection for you. During the mock inspection, we will use the same forms that the official surveyors will use to evaluate the clinic. You will receive a short report that will identify which areas of your clinic are at risk of non-compliance.