Federal and State Insurance programs are accompanied with complex rules and regulation for billing and documenting beneficiary claims for service. At F.O.R.C.E. we have experienced staff and resources to assist Homecare Agencies ensure their billing is accurate, complete and in compliance with laws and regulations that govern billing. We strive to ensure clients are receiving the legitimate and lawful reimbursements they are entitled to from the Medicare and Medicaid Programs.

PPS Revenue Recovery

We can assist you to identify potential Medicare PPS adjustments for episodes on which final claim payments have been received, so long as the claims remain within the statute of limitations for billing. We work with clinical and billing staff at the agency to identify, verify and make necessary adjustments to ensure appropriate reimbursements are requested by the agency and remitted by the RHHI. This is an interactive process whereby agency staff will also receive valuable training to help eliminate billing errors in future periods.

CLIA Billing and Recovery Project

Homecare Agencies are required by CMS to obtain a CLIA Waiver Certificate in order to perform certain lab procedures. This requirement comes as part of the Clinical Laboratory Improvement Act of1988 (CLIA) which changed the way lab services are certified and reimbursed through Medicare. F.O.R.C.E. has researched and implemented the CLIA Billing and Recovery Project as a mechanism to educate and assist homecare agencies to realize additional revenue available to them as CLIA Waived Labs.

Click Here to Calculate Your Potential Recovery On Clia Waived Lab Fees