NORTH DAKOTA HEALTH CARE
REVIEW, INC.
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Continued
Excellence in Health Care
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Medicare
Mandatory Case Review Areas
- Assistants
at Cataract Surgery
- EMTALA
Violations (Anti-Dumping)
- Notices
of Noncoverage
- Higher
Weighted DRGs
- DRG
Validation Review
- Requests
from the Centers for Medicare & Medicaid Services, Office of
Inspector
General, Fiscal Intermediaries, Medicare Integrity Program Contractors,
Program Safeguard Contractors, Rural Home Health Intermediaries, M+C
plans,
CDACs, and other referrals
- Potential
instances of gross or flagrant violations of professionally recognized
standards of care
Beneficiary
Complaints - Common Concerns
- Levels of Care
- Quality of Care
Settings
where NDHCRI can conduct quality concern reviews:
- Ambulatory
Surgical Centers
- Comprehensive
Outpatient Rehabilitation Facilities (CORFs)
- Emergency
Rooms
- Home
Health Agencies
- Hospices
- Hospital
Outpatient Areas
- Inpatient
Hospitals/Units
- Outpatient
Physical Therapy and Speech/Language Pathology Services
- Critical
Access Hospitals (CAHs)
- Skilled
Nursing Facilities (SNFs)
- SNF
Swing Beds within inpatient hospitals and CAHs
- Specialty
Hospitals (e.g., psychiatric and rehabilitation)
- Physician
Offices
- Community
Mental Health Facilities
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