Understanding Today’s Home Health Compliance Challenges

Home health agencies face unprecedented scrutiny through multiple audit types:

  • Targeted Probe and Educate (TPE) Audits: Three failed rounds can fast-track certification loss

  • Recovery Audit Contractor (RAC) Reviews: Focusing on improper payments and length of stays

  • Supplemental Medical Review Contractor (SMRC) Audits: Often triggered by previous audit findings

  • Unified Program Integrity Contractor (UPIC) Reviews: Most comprehensive government scrutiny

  • Medicaid Review Audits: State-specific compliance requirements

Comprehensive Home Health Compliance Solutions

Active Response & Defense

  • ADR Management
  • Pre and Post Bill Audit Assistance
  • Denials and Appeals Support
  • Expert Witness Testimony
  • Staff Training and Education
  • Quality Measure Improvement

Prevention & Preparation

Our CHAP and ACHC certified consultants provide:

  • Mock Surveys
  • Survey Readiness
  • Plan of Correction Development

Our Compliance Certified consultants provide:

  • Compliance Program Risk Assessments
  • HIPAA Privacy Risk Analysis

Why Choose SimiTree for Home Health Compliance

  • Proactive Protection

    Our pre-bill audits ensure claims meet all criteria before submission

  • Expert Guidance

    Certified consultants with CHAP and ACHC credentials and Compliance and Privacy certifications

  • Comprehensive Support

    From initial documentation through ALJ hearings

  • Proven Success

    Helping agencies maintain compliance across all audit types

Critical Audit Response Support

If you have a government audit, you will likely require assistance in these common next steps:

  • Thorough Additional Documentation Requests (ADRs) reviews
  • Timely responses to prevent red flags
  • Strategic appeals management
  • Expert representation at Administrative Law Judge (ALJ) hearings

Stay Compliant & Proactive 

Don’t wait for an audit to assess your compliance program. With agencies facing multiple simultaneous reviews and shortened response windows, preparation is crucial. SimiTree’s expert team helps you:

  • Establish robust documentation processes
  • Implement preventive audit procedures
  • Navigate complex regulatory requirements
  • Protect your certification and reputation

Bundle & Save

Our home health compliance and regulatory services naturally complement several other key service areas:

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

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

Frequently Asked Questions