Non-Skilled & Home Care Compliance and Regulatory Risk Solutions

Navigate Home Care & Non-Skilled Compliance with Confidence

Are you feeling overwhelmed by state-specific regulations and payer audits? You’re not alone. As a home care agency, you face unique challenges in meeting state requirements while managing increased scrutiny from Medicaid and private insurance companies.

Our team of compliance experts specialize in non-skilled and home care state-specific regulations and know exactly what auditors look for in your billing practices. From documentation requirements to evolving state regulations, we understand the complexity of staying compliant in your billing practices.

Navigate Home Care & Non-Skilled Compliance with Confidence

Are you feeling overwhelmed by state-specific regulations and payer audits? You’re not alone. As a home care agency, you face unique challenges in meeting state requirements while managing increased scrutiny from Medicaid and private insurance companies. Our team of compliance experts specialize in non-skilled and home care state-specific regulations and know exactly what auditors look for in your billing practices. From documentation requirements to evolving state regulations, we understand the complexity of staying compliant in your billing practices.

We offer tailored solutions including:

State-specific regulatory compliance guidance
Mock surveys to prepare for state or accrediting body surveys.
Billing audit preparation for Medicaid and private insurance
Compliance and Privacy Program assessment
Documentation review and risk management

Let us help you navigate your state’s regulatory requirements with confidence, minimize audit risks, and maintain billing compliance across all payer sources.

Overcome Your Non-Skilled/Home Care Compliance Challenges with SimiTree Solutions

Staff Education: Assist your staff as they navigate the ever-changing compliance standards while continuing to provide compassionate care.
Electronic Visit Verification (EVV) Audits: Ensure your team maintains compliant EVV practices to meet state mandates and prevent billing denials through accurate visit tracking and documentation.
Pre and Post Pay Auditing Services:
- Documentation accuracy to ensure records meet regulatory requirements and support proper reimbursement.

Survey Readiness: Stay ahead of changing regulations that impact home care services. Help your staff prepare for your upcoming survey.
Compliance Program Risk Assessment: Identify and address potential compliance program gaps and risks before they become issues.

Our goal isn’t just to keep you compliant – it’s to help your home care business thrive in today’s complex healthcare industry.

Trust in Accredited Experience

Our compliance team members are certified consultants for CHAP and ACHC, bringing accreditation-level expertise to every client engagement. This certification ensures we deliver guidance that not only meets regulatory requirements but also aligns with the highest industry standards for quality care.

With SimiTree’s non-skilled/home care compliance services, you can:

Reduce regulatory risks
Improve quality of care
Optimize reimbursement
Enhance operational efficiency
Focus more on patient care

Don’t let compliance concerns hold your home care agency back. Partner with SimiTree and turn regulatory challenges into opportunities for growth. Let’s work together to build a stronger, more compliant home care agency that stands out in your community.

Empower Your Agency with SimiTree’s Expertise

Our Services Include:

Mock Surveys
Survey Readiness
Plan of Correction Development & Implementation
Full Compliance Assessments
HIPAA Privacy Risk Analysis
Pre-Bill Audits

ADRs
Denials and Appeals
Audit Assistance for all audits by government contractors
Expert Witness Testimony
Staff Training and Education

Let us help you navigate your state’s regulatory requirements with confidence, minimize audit risks, and maintain billing compliance across all payer sources.

Benefits of SimiTree Compliance Services

Comprehensive Risk Mitigation

Gain insights from our certified healthcare leaders with extensive home care experience.
Benefit from our understanding of medical review processes.
Develop robust processes, procedures, and policies to address vulnerabilities in billing, operations, and clinical documentation.

Thorough Audits & Appeals Support

Receive assistance with Additional Documentation Requests and navigate payer or external audits with confidence.
Access ongoing compliance resources related to payment regulations and key audit focus areas.

Proactive Pre-Bill Audits

Ensure accuracy with billing compliance audits tailored to home care.
Strengthen your clinical documentation and processes to support coverage from payers.
Minimize claim denials and optimize reimbursement for your home care services.

Comprehensive Survey Readiness

Prepare for surveys with mock assessments and targeted readiness support.
Develop and implement effective Plans of Correction when needed.
Train your team on regulatory requirements.

Bundle & Save

Our non-skilled and home care compliance and regulatory services naturally complement several other key service areas:

Home Care Mergers & Acquisitions (M&A)
Home Care Billing (RCM)
Home Care Operational Consulting
Home Care Quality Assurance and Performance Improvement (QAPI)

If you’re considering any of these home care services or our compliance and regulatory offerings, ask about our bundled solutions for comprehensive support and cost savings.

Frequently Asked Questions

Home care agencies face several key compliance challenges:

Maintaining accurate documentation for services provided
Ensuring caregiver qualifications and training meet regulatory standards
Adhering to state-specific licensing and certification requirements
Implementing effective HIPAA compliance measures
Navigating complex billing and coding regulations

SimiTree’s expert team helps you address these home care compliance challenges comprehensively, reducing your risk and enhancing your agency’s performance.

We recommend that home care agencies conduct internal compliance audits at least quarterly and an external audit annually. However, the frequency may vary based on your agency’s size, services offered, and risk profile. Regular audits help identify potential issues early, allowing you to address them proactively. SimiTree can help you develop a customized home care audit schedule and provide tools to streamline the process.

Non-compliance in home care can have serious consequences, including:

Financial penalties and fines
Loss of licenses or certifications
Exclusion from government healthcare programs
Damage to reputation and loss of client trust
Potential legal action

By partnering with SimiTree, you can significantly reduce these home care compliance risks and ensure your agency maintains the highest standards of compliance.

Staying informed about home care regulatory changes is crucial. We recommend:

Subscribing to industry newsletters and regulatory updates
Attending relevant home care conferences and webinars
Joining professional associations in the home care field
Partnering with compliance experts like SimiTree who provide ongoing education and support

Our team at SimiTree constantly monitors home care regulatory changes and provides timely updates and guidance to our clients.

Technology is increasingly important in maintaining home care compliance:

Electronic Health Records (EHRs) improve documentation accuracy
Scheduling software helps ensure appropriate caregiver assignments
Compliance management systems streamline audit processes
Secure communication platforms enhance HIPAA compliance

SimiTree can help you select and implement the right technology solutions to support your home care compliance efforts.

SimiTree’s approach to home care compliance is unique because:

We focus exclusively on post-acute care, including home care, giving us specialized expertise
Our team includes expert auditors and former surveyors who understand home care compliance from all angles
We provide comprehensive solutions that address all aspects of home care compliance, from risk assessment to ongoing support
Our approach is tailored to each home care agency’s specific needs and challenges

By choosing SimiTree, you’re not just getting a consultant – you’re gaining a partner dedicated to your home care agency’s success and compliance.

Absolutely. We believe that compliance is essential for home care agencies of all sizes. SimiTree offers scalable solutions that can fit various budgets and needs. Remember, the cost of non-compliance in home care – in terms of penalties, lost business, and damaged reputation – is often much higher than investing in proper compliance measures. We work with you to develop a home care compliance program that fits your agency’s size and resources.