Understanding Fraud, Waste and Abuse for Long Term Care and Adult Family Home is becoming increasingly more complex. Learn more to protect your residents and providers.

1. Understanding Your Impact
in Fraud, Waste & Abuse
Adult Family & Long Term Care
Elite Precision Consulting

2. How Are You
Impacted?
pproximately 46% of Washington based AFH
providers house Medicaid-eligible residents. This
means increased awareness to requirements when
obtaining payment for reasonable and necessary
services.
The Office of State Auditor performs frequent audits
to assess the accuracy of payments made. This is
typically done based on a 2 or 3 year reporting
period. The focus of these audits are:
Accuracy and Completeness of physician orders
Accuracy and Completeness of clinical authorizations
Potential Improper Payment
Determination of Fraud
Continuous oversight of State's Medicaid programs
$760 B
With this focus, government agencies are expected to
increase their FWA resources by nearly 40% in the upcoming
years.
IN WASTE IS ESTIMATED
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3. Why Do We Care?
orking alongside physicians and healthcare
professionals for over 15 years, we've seen the
stress, frustration and anxiety behind running a
profitable business and ensuring quality care for
patients. We've built a foundation of excellence,
actionable education and quality outputs so the
providers can get back to their first love!
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because of their in-depth, extensive knowledge
of the industry.
"I highly recommend
Elite Precision...
Ciara also is a woman of the highest integrity, professionalism and delivers
results that can be utilized immediately producing a very high return on
investment."
- M. Kuechler, Chief Operating Officer

4. Why It's Important
any providers have been faced with similar audits as
Cozy Corner Adult Day Health.
The purpose of this audit was to determine whether
Cozy Corner obtained the required orders and
clinical authorizations for ADH services for each
Medicaid member.
Only having an impact on 47 members, this is a
small scale audit compared to many adult home
providers locally in Washington.
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$955K
This being over a 2 year reporting period. Without proper
expertise, education and documentation, this audit could
have impacted both the residents and stakeholders.
IN POTENTIAL IMPROPER PAYMENTS
Preparation. Expertise. Awareness are Essential
https://www.mass.gov/doc/audit-of-the-office-of-medicaid-masshealth-review-of-claims-
paid-for-services-provided-by-cozy/download

5. How We Serve
ollating historical data over the past 7 years from
federal agencies, clients, focused audits and various
federal-based educational tools, we've created a
easy to understand model in understanding your risk
vulnerability and gaps.
We understand how intricate adult home care can
be and place value on resident safety along with
business goals realization.
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Let Us Help!
bringing a proactive, professional approach
and ensuring our organization was complaint.
"They provided cutting edge
auditing & education...
Elite Precision Consulting has always educated us on potential changes in
medical claim coding, billing, compliance and healthcare changes.'
- M McMeechan, Chief Operating Officer

6. Let's Get Started
Contact Us
Today for Free
Consultation
We Are Here to
Help
Phone: 800-674-3732
Email: info@eliteprecisionconsulting.com
Website: www.eliteprecisionconsulting.com