Don’t Let Medical Reviews Derail Care

U.S.-based clinicians guide you through TPE, ADR, RAC, SMRC, CERT, and UPIC Audits, including chart compilation, review, appeals and training.

Healthcare Provider Solutions - Medical Review Services
REVIEWS CAN SHAKE CONFIDENCE.
WE HELP YOU REGAIN IT.

YEARS IN BUSINESS

AGENCIES SUPPORTED NATIONWIDE

OF CHARTS REVIEWED BY US-BASED CLINICIANS

EMR SYSTEMS UTILIZED

STOP CHASING CLAIMS. START GROWING YOUR AGENCY.
25 YEARS IN BUSINESS
130+ AGENCIES SUPPORTED NATIONWIDE
100% US-BASED SUPPORT
15+ EMR SYSTEMS UTILIZED

Our U.S.-based clinicians know exactly what reviewers look for, and how to help your agency meet every requirement, on time.

HPS brings clarity and control to an often chaotic process.

Whether you’re facing a post-payment audit or a targeted probe, our clinicians step in quickly to assess what’s been requested, identify risk areas, and guide your team through assembling and submitting compliant records.

We don’t just react to the review, we help your agency understand the “why” behind each finding, strengthen documentation for future claims, and reduce the chance of repeat denials.

The sooner we start, the stronger your submission.

Our U.S.-based clinicians know exactly what reviewers look for, and how to help your agency meet every requirement, on time.

HPS brings clarity and control to an often chaotic process.

Whether you’re facing a post-payment audit or a targeted probe, our clinicians step in quickly to assess what’s been requested, identify risk areas, and guide your team through assembling and submitting compliant records.

We don’t just react to the review, we help your agency understand the “why” behind each finding, strengthen documentation for future claims, and reduce the chance of repeat denials.

The sooner we start, the stronger your submission.

Our U.S.-based clinicians know exactly what reviewers look for, and how to help your agency meet every requirement, on time. The sooner we start, the stronger your submission.

Our U.S.-based clinicians know exactly what reviewers look for, and how to help your agency meet every requirement, on time.

HPS brings clarity and control to an often chaotic process.

Whether you’re facing a post-payment audit or a targeted probe, our clinicians step in quickly to assess what’s been requested, identify risk areas, and guide your team through assembling and submitting compliant records.

We don’t just react to the review, we help your agency understand the “why” behind each finding, strengthen documentation for future claims, and reduce the chance of repeat denials.

The sooner we start, the stronger your submission.

TIPS FOR SUCCESS

HOW SUCCESSFUL AGENCIES PREPARE FOR MEDICAL REVIEW
Medical Review Records

1. Prepare Your Records

  • Enroll in electronic submission to ensure fast confirmation and tracking.
  • Assign one clinical lead to oversee ADR intake and chart assembly.
  • Organize all supporting documentation before upload.
Medical Review Accuracy

2. Check for Accuracy

  • Review every chart to ensure compliance with Conditions of Payment.
  • Verify physician orders, signatures, and documentation dates.
  • Confirm that all medical necessity elements are clearly documented.
Medical Review Submit

3. Submit with Confidence

  • Double-check submission deadlines and upload confirmations.
  • Keep a copy of every submitted file and acknowledgment notice.
  • Track status daily to identify potential re-reviews early.
WHY AGENCIES CHOOSE HPS FOR
MEDICAL REVIEW CONSULTING

Government contractors use multiple review programs, and each one has different expectations and timelines. HPS coordinates the entire response, from assembling and validating medical records to finalizing for electronic submission, so your team isn’t guessing what to do next. When cases escalate, we guide you through every level of the appeals process, up to and including ALJ appearances when needed. The result is a structured path that helps you meet deadlines, avoid non-response errors, and keep revenue moving during a high-pressure period.

Reviews test far more than checkboxes, they test whether your documentation demonstrates medical necessity and compliance. Our clinicians complete a detailed chart review prior to submission, confirming orders, signatures, dates, and required elements so each record is defensible. We help your agency implement practical readiness habits, routing letters the day they arrive, organizing team ownership, and using electronic submission for proof of timely acceptance. With post-payment reviews at an all-time high, a disciplined pre-submission process is the surest way to reduce avoidable escalations and protect cash flow.

HPS transforms every review into a chance to strengthen your team’s understanding and confidence. Our consultants explain what reviewers look for, why certain findings occur, and how to improve documentation for future submissions. Through the HPS Alliance and our ongoing educational programs, your staff has access to training and resources guided by Melinda A. Gaboury’s leadership in home health and hospice compliance. Her focus on clarity and education drives the standards we bring to each engagement, ensuring agencies gain not only review support but long-term compliance growth.

Compliance That Protects What You've Built

Secure your agency's reputation, revenue, and readiness, starting with CHAP certified support.

 CHAP-Verified QAPI Program

Confidence Comes Standard with CHAP-Verified QAPI Programs

HPS delivers CHAP-verified QAPI programs designed to meet CMS Conditions of Participation while supporting continuous, agency-wide performance improvement. Our QAPI framework is developed and supported by consultants certified in both CHAP and ACHC standards, ensuring your program aligns with accreditation expectations, regulatory requirements, and real-world operations.



CHAP-Verified QAPI Framework


CMS Condition of Participation Alignment


Survey-Ready Documentation & Oversight


Data-Driven Performance Improvement
LESS STRESS. MORE STABILITY. STRONGER COMPLIANCE.
Workshops Icon

RESPOND TO MEDICAL REVIEWS WITH CLARITY, NOT GUESSWORK

Workshops Icon

PARTNER WITH 100% US-BASED CLINICIANS WHO KNOW YOUR WORLD

Workshops Icon

REDUCE ESCALATION RISK BY GETTING IT RIGHT THE FIRST TIME

Workshops Icon

STAY ORGANIZED WHEN REVIEW TIMELINES ARE TIGHT

Workshops Icon

PROTECT REVENUE BY CATCHING DOCUMENTATION ERRORS BEFORE BILLING

Workshops Icon

BUILD A FUTURE-READY AGENCY THAT GROWS WITHOUT RISK

The Audit Letter is here. Let’s Handle it Together.

Our U.S.-based clinicians guide your agency through every stage, from chart preparation to appeals, so you can move forward with confidence.

A medical review notice can feel overwhelming, but you don’t have to navigate it alone. Our clinical consultants know what reviewers are looking for and how to assemble complete, defensible documentation under tight deadlines.

We’ll help you understand each request, organize your records, and respond strategically, without pulling your staff away from patient care.

Talk to a clinical consultant about your current review.

The Audit Letter is here. Let's Handle it Together.

Our U.S.-based clinicians guide your agency through every stage, from chart preparation to appeals, so you can move forward with confidence.

A medical review notice can feel overwhelming, but you don’t have to navigate it alone. Our clinical consultants know what reviewers are looking for and how to assemble complete, defensible documentation under tight deadlines.

We’ll help you understand each request, organize your records, and respond strategically, without pulling your staff away from patient care.

Talk to a clinical consultant about your current review.

Our U.S.-based clinicians guide your agency through every stage, from chart preparation to appeals, so you can move forward with confidence.

The Audit Letter is here. Let's Handle it Together.

Our U.S.-based clinicians guide your agency through every stage, from chart preparation to appeals, so you can move forward with confidence.

A medical review notice can feel overwhelming, but you don’t have to navigate it alone. Our clinical consultants know what reviewers are looking for and how to assemble complete, defensible documentation under tight deadlines.

We’ll help you understand each request, organize your records, and respond strategically, without pulling your staff away from patient care.

Talk to a clinical consultant about your current review.

Medical Review - Healthcare Provider Solutions - HPS

Two Free Evaluations. Two Critical Revenue Functions.

Choose between a receivables performance review or a coding & OASIS accuracy assessment, each designed to give leadership clear, structured insight into a different side of revenue performance.

Free AR Evaluation Analysis

Gain clear visibility into your receivables, build confidence in your billing performance, and take a proactive approach to managing cash flow.

What this review provides:
  • Clear visibility into how your receivables are performing
  • Insight into what’s working well and where payments may be slowing
  • A proactive way to manage cash flow with confidence
Best for agencies concerned about cash flow delays or growing AR
Request Free Review

Free Coding & OASIS Review

A timely review of your charts can uncover missed revenue opportunities and highlight patterns that aren’t visible in standard reporting.

What this review provides:
  • An objective assessment of coding accuracy and OASIS alignment
  • A second look at how consistently documentation supports the codes required
  • Clear, practical observations that can be used to validate current performance or fine-tune process
Best for agencies concerned about coding performance.
Request Free Review
CONFIDENTLY NAVIGATE POLICY AND REIMBURSEMENT SHIFTS
Healthcare Provider Solutions - HPS
CMS Rule Tracking
Healthcare Provider Solutions - HPS - US-Based
100% US-Based Team
Healthcare Provider Solutions - HPS
On Call Consulting
Healthcare Provider Solutions - HPS
Regulatory Education & Oversight
CMS Rule Tracking
100% US-Based Team
On Call Consulting
Regulatory Education & Oversight

Join The HPS Alliance!

With an annual subscription to the HPS Alliance, you’ll gain access to the tools needed to build and sustain a successful agency. Led by Melinda Gaboury, CEO – and our team of clinical consultants – our exclusive webinars, workshops, resources and consulting will empower your agency to achieve success!

ADDITIONAL CONSULTING SERVICES
Clinical Consultant on Call
Operations Process Review
Clinical Compliance Consulting
RECENT ARTICLES
2027 Hospice Proposed Rule: Key Payment Updates, SSVI, and What Providers Need to Know

2027 Hospice Proposed Rule: Key Payment Updates, SSVI, and What Providers Need to Know

The Hospice 2027 Proposed Payment and Wage Index Rule has officially been released, and it’s one of the most comprehensive updates the hospice industry has seen in recent years. Issued at the beginning of April, this proposed rule goes beyond routine payment adjustments, introducing a broader range of policy updates and new considerations that providers need to understand and prepare for.

2027 Hospice Proposed Rule: Key Payment Updates, SSVI, and What Providers Need to Know

Understanding the Updated Advanced Beneficiary Notice of Non-Coverage Form

An important update providers should implement immediately is the revised fee-for-service ABN, or Advanced Beneficiary Notice of Non-Coverage form. This form is used when a patient requests, or is expected to require, services that are not covered by Medicare, making it a critical component of both patient communication and proper billing practices.