Medical Records Review

Whether you are a new or established PACE program, preparing for the CMS PACE audit is critical to your success.

PACE organizations are audited by the Centers for Medicare & Medicaid Services (CMS) every year for their first three years—known as trial audits—and approximately every three years thereafter.

On Lok PACEpartners offers PACE audit expertise to improve the quality of your documentation and identify areas at risk of non-compliance before your next audit.

As CMS PACE clinical auditor, our CMS PACE Specialist Brian King, R.N., M.Ed., participated in over 50 CMS audits in the role of clinical element lead, medical record review trainer, or provision of service team member. With Brian’s in-depth knowledge of PACE, and his 26 years of healthcare experience, we can accomplish an independent assessment of your medical records by:

  • Reviewing documentation to ensure your EHR system meets all PACE compliance standards

  • Identifying and reporting issues of potential non-compliance

  • Improving documentation accuracy to meet regulatory requirements, including evaluating and processing selected dispute resolutions (SDRs), grievances, and appeals.

Be “audit-ready” at every level

Although the audit is usually led by the PACE organization’s Quality department, all PACE staff are responsible for ensuring a successful audit. On Lok PACEpartners can help train your team on the audit process, and assist during and after the audit, from guidance on completing RAI, RCA, and impact analysis to assistance with implementing and sustaining corrective action plans.

Contact us today to learn more about our services and to schedule a virtual or onsite review of your medical records.

Sanford Rodgers, Director, On Lok PACEpartners

Telephone: 415-292-8667