Pre-claim Review (PCR) Services

LKN Strategies provides pre-claim review (PCR) audits to ensure clinical and billing compliance with Medicare regulations is met prior to claim submission. This is a pre-bill service that provides meticulous review of all clinical documentation that is present in the medical record to support the 30-day claim period.  This review always includes FTF encounter compliance and all service assessments, evaluations, daily notes, communication notes, and miscellaneous items like physician follow-up encounters, labs, etc. It includes a comparison of the medical record documentation to the UB-04 claim to ensure the claim is accurate and supported.   

This service assists agencies in identifying claim issues and coverage criteria deficiencies to avoid future denials during an ADR request.  It also improves agency overall compliance as documentation trends that affect outcomes, quality, timely service, ERD/hospital utilization, Compliance are summarized and sent to the agency for discussion and implementation of a corrective action plan.