C3 Advisors specializes in home health and hospice compliance matters from conducting routine compliance reviews on selected medical records, to assisting with government audits, investigations and due diligence reviews.

We work with our clients to not only address compliance matters after problems are found but also to prevent them from occurring in the first place by providing in-depth education to all staff members and assisting with implementation of working compliance programs designed as operational mainstays.

Each of audit is approached in a systematic way to ensure consistent results that can be used to identify and correct process, system and documentation weaknesses. Our approach is collaborative and produces a full, detailed report once preliminary results are reviewed with management and clinical teams.

We work with clients who have been selected for Targeted Probe and Educate (TPE) reviews, Unified Program Integrity Contractor (UPIC) audits, Supplemental Medical Review Contractor (SMRC), Office of the Inspector General audits, MAC high risk audits and more. We have deep experience in working through audit issues and preparing winning appeals that result in restoration of payment.

The appeals process for Medicare can be a daunting proposition for most providers. It is fraught with different rules that apply to each level. Our process is designed to ensure that comprehensive appeals rooted in applicable regulatory content are prepared and filed on time to ensure a smooth process and avoid recoupment of funds for as long as possible.

It is a fact that Medicare auditors have ever changing tools in their arsenals. Their main goal is to find any way they can to deny payment. Our goal is to ensure that payment for compliant services provided to Medicare beneficiaries are received and retained.

In recent UPIC and SMRC audits our work resulted in recovery of more than 90% of previously denied Medicare payments, significantly better than the 50% national average.

We often work with those interested in acquiring a home health or hospice organization to measure and quantify compliance risk. Our due diligence audits are structured to meet client needs and can be expansive or focused only on chart and documentation reviews.

Wage and hour matters are often problematic for home health and hospice providers and can result in unintended and expensive complaints and investigations. We help our clients to develop compensation programs that are compliant and responsive to their needs. We can also work with counsel and agency leadership to address investigations and other compliance concerns as they arise.