Marcum LLP’s experience within the Healthcare industry covers the full continuum of care with a special focus within the post-acute care geriatric segments of the industry, hospitals, and physician practices.
We go beyond providing traditional audit and tax services to the industry and truly understand the clinical, regulatory, reimbursement and operational challenges facing today’s healthcare industry.
To best serve our clients we have teamed up with Celtic Consulting, a post-acute care advisory firm, concentrated in clinical operations and regulatory compliance. Celtic serves hundreds of clients as subject matter experts across the country, and National, Regional and State Professional Associations as innovative thought leaders. At its core, Celtic provides:
- Reimbursement and Regulatory guidance
- Clinical Performance and Enhancement initiatives
- PDPM/PPS/MDS/CMI expertise
- Medical Billing and Coding Division
- Payroll-Based Journal (PBJ) Reporting analysis
- 5-Star Improvement Programs (QAPI) and Quality Auditing
- Clinical Care Management
- Revenue Integrity Audits
- Compliance Solutions including Medicare
- Compliance Auditing
- Litigation Support
- Mergers and Acquisitions Due Diligence
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.
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.
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.
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.
ADVISORS AND EDUCATORS TO:
- American Health Care Association
- Association for Long-Term Care Financial Managers
- American College of Health Care Administrators
- American Association of Post-Acute Care Nurses
- Connecticut Association of Health Care Facilities
- New York State Healthcare Facilities Association
- Massachusetts Senior Care Association
- Rhode Island Health Care Association
- Health Care Association of New Jersey Care Providers
- PointClick Care Solution Provider Partner
Marcum 3-Year Nursing Home Statistical Review
The 2023 Marcum 3-Year Nursing Home Statistical Review includes a deep dive into the distinct stages of the pandemic – the pre-COVID environment, the heart of COVID, and then what some might call the beginning of COVID recovery.