Healthcare Clinical Services

POST-ACUTE CARE OPERATIONS

Celtic offers full spectrum solutions, designed to address obstacles from end to end. Celtic’s scope of reimbursement and revenue services have guided Skilled Nursing Facilities across the country to recoup millions of dollars in unrealized revenue. The firm’s accomplished Clinical Reimbursement specialists understand the detailed workings of the exceptionally regulated reimbursement process and recognize opportunities for improvement. The firm provides advisory services at all levels of Denials and Appeals with extensive knowledge of the MDS 3.0 RAI Manual. The Medical Billing and Coding Division provides complete management of an organization’s accounts receivable and
revenue collections for Federal and State insurers and private payors.

QUALITY IMPROVEMENT

Celtic’s success with enhancing Quality Improvement for many SNF clients is are achieved by introducing integrated and proven strategies and customizing them to blend with existing processes. Improved quality and top tier star ratings in part function as gateways for joining an Accountable Care Organization (ACO), along with other bundled partner projects. Celtic’s success in enhancing Quality Improvement stems from introducing integrated, proven strategies for many organizations, targeted efforts on areas often yields a significant positive effect on the star rating and improving overall quality. Our vast experience with the nuances of the Payroll Based Journal (PBJ) Reporting System positions us to offer leadership for improving facility metrics.

COMPLIANCE SOLUTIONS

The firm’s external analysis has served as an integral tool in managing regulatory compliance and avoiding potential fines and civil monetary penalties for hundreds of long-term care providers. Compliance program design, implementation, and evaluation form the cornerstone of our solutions, risk assessment, auditing, and monitoring, paired with investigation support and monitorship (e.g., Independent Review Organization, Board Advisor).

CLINICAL CARE MANAGEMENT

With concentration surrounding education and training, Celtic equips our partners with efficient processes and utilizes our expertise to identify opportunities for advancement. Tailored strategies that aid organizations to establish reliable infection prevention strategies, achieve exceptional patient-care outcomes in facilities nationally and confidently enter their respective State Department of Health Annual Survey.

INNOVATIVE PRODUCTS

PDPM Prodigy, a PDPM calculator helps users determine the financial impact that subtle clinical changes have on their average daily rate, and ultimately predict potential reimbursement. Instantaneous dollar impact on both a daily, and per episode basis. PDPM Prodigy allows access to reports that identify the average Case Mix Index
for each of the PDPM components (PT/OT/ST/Nursing/NTA); to monitor changes over time and compare to industry standards. PDPM Prodigy is available through subscription.