← All audiences
i. Healthcare Providers
The record decides the reimbursement. We make sure it can carry the claim.
From program design through examination.
From program design through examination.
Providers live inside the reimbursement system — PDGM, PDPM, the MDS and OASIS, the cap — where payment, survey, and audit all ride on the same documentation. In FY2025, $28.83 billion in Medicare fee-for-service payments were improper, most from insufficient documentation, and CMS now flags outliers by data before any complaint. The exposure isn’t the care; it’s whether the record proves it.
The engagement
Defensible documentation across payment, survey, and audit; recovered and protected reimbursement; a working audit-response system; and a written read on your exposure before a reviewer finds it.
Week 1 — intake: payment, survey, and audit posture, and exposure. Weeks 2–4 — documentation and coding review against the coverage rules, gaps flagged pre-bill. Ongoing — pre-request review, coaching, and audit response as demands arrive.
Regulatory context
The ground shifted in 2026: CMS imposed a nationwide six-month moratorium on new home-health and hospice enrollment (May 13, 2026) and its contractors suspended payments to hundreds of providers flagged as data outliers — the suspension first, the investigation after. The same record that prices your claim now also triggers your audit, which is why proactive, coverage-calibrated review is the difference between defensible and indefensible.
Frequently asked
What makes Precisian different from a billing or compliance vendor?
We’re full-service across the lifecycle and specialize where scrutiny is highest — and we read your data the way CMS’s analytics do, before the payer asks, backed by licensed investigations no consultancy carries.
Can you help before an audit, not just after?
Yes — pre-request, coverage-calibrated review is the edge: we find the gap while the record can still be corrected.
Which provider types do you work with?
All nine — SNF, home health, hospice, hospitals, physician practices, FQHCs and RHCs, behavioral health, DME suppliers, and Texas IDD waiver programs.
How critical is credentialing and enrollment right now?
Very — billing privileges begin at enrollment, and CMS’s 2026 moratorium restricts new home-health and hospice enrollment and certain ownership changes, so timing and structure are strategic. We manage enrollment, revalidations, payer credentialing, and CHOW so cash flow never stalls.
Are you a law firm?
No. We’re the expert layer between your operation and your counsel — consultants and licensed investigators who build the evidence both of you need. We can serve as testifying experts. Nothing here is legal advice.
30 minutes. No pitch. We open the case file together — and recommend the next step.