What We Offer

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When agencies decide to outsource OASIS review and coding, the conversation often starts with one question:

"What's your turnaround time?"

While timeliness matters, it should never be the only factor driving your decision.

The reality is that OASIS and coding directly impact reimbursement, quality outcomes, HHVBP performance, risk adjustment, survey readiness, and audit defensibility. Choosing the wrong partner can create compliance risks, increase denials, and leave your clinicians frustrated. Choosing the right partner can strengthen your entire clinical and operational process.

Not all outsourced service providers are created equal.

Here are the questions every agency should ask before entering a partnership.

OASIS review and coding require far more than the ability to assign diagnosis codes or answer assessment questions.

Your review team should understand how documentation, coding, OASIS accuracy, PDGM, quality measures, and Medicare regulations work together.

Ask:

• How long have you been providing OASIS review and coding services?
• What certifications do your reviewers hold?
• Do your reviewers have actual home health clinical experience?
• Are they knowledgeable in PDGM, HHVBP, and OASIS-E requirements?

Look for certifications such as:

• HCS-D®
• BCHH-C™
• HCS-O®
• COS-C®
• COQS®

The strongest reviewers combine certification with real-world home health experience.

The home health regulatory environment changes constantly.

Your outsourced partner should not only know the rules—they should be actively monitoring changes and adjusting their review processes accordingly.

Ask:

• How do you ensure compliance with CMS regulations and ICD-10 coding guidelines?
• How do you stay current on OASIS and coding updates?
• What quality assurance processes are in place?
• How frequently are reviewers audited internally?

A quality review company should be auditing itself just as diligently as it audits your charts.

Fast isn't always better.

A chart returned quickly but inaccurately can cost far more than a chart that takes an extra few hours to review thoroughly.

Ask:

• What is your average turnaround time?
• Do you offer expedited reviews?
• Are services available on weekends and holidays?
• What happens when a chart is placed on hold for clarification?

More importantly, ask how they balance timeliness with accuracy.

You want a partner who values both.

Successful outsourcing relationships are built on communication.

Both parties need clearly defined points of contact and established expectations.

Ask:

• How are questions communicated to agency staff?
• What is the expected turnaround once clarification is received?
• Will dedicated reviewers be assigned to our agency?
• Will we have an account manager or primary contact?

Consistency matters. Reviewers who become familiar with your agency's clinicians, workflows, and documentation habits can provide more meaningful feedback and identify trends earlier.

Many implementation challenges occur simply because responsibilities were never clearly defined.

Before the first chart is reviewed, establish a workflow that outlines who is responsible for each step.

Ask:

• How do you access documentation?
• How do you know when a chart is ready for review?
• Are you familiar with our EMR platform?
• How are completed reviews returned?
• Will coding and OASIS recommendations include supporting rationale?

The clearer the process, the smoother the partnership.

One of the greatest benefits of outsourcing is the opportunity to strengthen clinician documentation.

The best coding and OASIS partners don't simply make corrections.

They explain why.

Ask:

• Do you provide clinician feedback and education?
• Will recommendations include supporting documentation and rationale?
• Can you assist with ongoing OASIS education?
• Do you provide regulatory updates and alerts?

Every review should be an opportunity to improve future documentation quality.

Outsourcing OASIS review and coding is not simply a staffing solution.

It is a strategic partnership that affects compliance, reimbursement, quality outcomes, clinician development, and agency performance.

The right partner does more than review charts.

They help strengthen documentation, educate clinicians, identify risks before they become deficiencies, and support your agency's long-term success.

At Clover Consulting, we believe OASIS and coding should do more than check a box. They should tell the patient's story accurately, support medical necessity, protect reimbursement, and help agencies deliver exceptional care.

Because accuracy matters. Compliance matters. And your patients deserve both.