Patient Eligibility Checks
Prevent revenue loss with automated insurance eligibility monitoring. Our system runs daily checks for all active patients, instantly alerting you to coverage changes before they
Managing Medicare’s Review Choice Demonstration (RCD) process doesn’t have to mean juggling spreadsheets, searching through patient records, and manually organizing disconnected documentation.
Finale Health brings your RCD pre-claim review workflow into one organized workspace, helping home health agencies prepare supporting documents, track submissions, and maintain clear records of review decisions.
For home health agencies participating in Medicare’s Review Choice Demonstration, preparing and tracking pre-claim reviews can become a time-consuming administrative responsibility.
Your team needs to identify the right patient documentation, prepare supporting files, record submission details, and follow up on review outcomes—all while maintaining accurate clinical records.
Without an organized workflow, agencies may encounter:
Scattered documentation: Supporting clinical records can be difficult to locate when preparing a review packet.
Time-consuming preparation: Gathering plans of care, orders, assessments, and additional documents takes valuable administrative time.
Limited status visibility: Tracking which requests are pending, submitted, or affirmed can become challenging.
Disconnected review records: Tracking numbers, affirmation dates, and non-affirmation details may be stored across different files or spreadsheets.
These challenges create unnecessary administrative effort and make it harder to maintain a clear picture of each review’s progress.
Finale Health helps bring the process together.
One Organized Workflow. From Documentation to Review Decision.
Finale Health’s RCD Tracking feature is designed to help home health agencies manage the documentation and tracking activities associated with Medicare’s pre-claim review process.
Instead of relying on separate spreadsheets and disconnected files, your team can organize review documentation and record submission progress within your existing EMR platform.
From preparing supporting documents to monitoring review outcomes, Finale Health provides a structured way to manage the information your team needs throughout the process.
Key Features
1. Identify Pending RCD Requests
Quickly find cases requiring RCD attention. Keep pending requests organized so your administrative and billing teams can determine which cases need documentation preparation or follow-up.
2. Organize Supporting Clinical Documentation
Prepare review packets using available documentation from the patient’s electronic record.
Select relevant supporting documents, including:
Plans of Care
Physician Orders
OASIS Assessments
Additional Clinical Documentation
Bring the required materials together without having to manage a separate collection of files.
3. Prepare and Track Review Packets
Keep selected documents associated with each review request. Once the packet is prepared and submitted through the appropriate review channel, record its submission information within Finale Health.
This provides a more structured way to maintain documentation and track the progress of each request.
4. Record Review Decisions
When review results become available, your team can document important information, including tracking numbers, affirmation dates, and discipline-specific outcomes.
For non-affirmed requests, record the stated reasons and remarks to support follow-up and documentation review.
5. Monitor RCD Status
Maintain visibility into requests as they move through the review process.
See which cases are awaiting action, which have been submitted, and which have received affirmation decisions.
With review information kept together, your team can follow progress without having to reconstruct the history of each request.
Step 1: Identify Pending Requests
Access RCD Tracking and review cases requiring attention. Select the appropriate patient request to begin preparing the supporting documentation.
Step 2: Select Supporting Documents
Choose the relevant clinical records available in Finale Health, including plans of care, physician orders, OASIS assessments, and other supporting documents.
Step 3: Prepare Your Review Packet
Keep the selected documentation organized within the associated review request, making it easier for your team to verify the materials before submission.
Step 4: Record Submission Information
After submitting the request through the appropriate Medicare review channel, record the submission date and related details in Finale Health to maintain a clear tracking record.
Step 5: Document Review Outcomes
When a decision is received, update the request with the tracking number, affirmation information, and applicable review results.
Step 6: Follow Up with Confidence
Review each request’s recorded status and supporting information to identify cases that require further attention, additional documentation, or internal follow-up.
RCD Tracking is more than a place to store documents. It helps create a consistent administrative process for managing review-related information.
Reduce Administrative Back-and-Forth
Keep review documentation and tracking information together, reducing the need to search across disconnected files and spreadsheets.
Improve Documentation Organization
Maintain supporting clinical records alongside their associated RCD requests for easier reference and review.
Increase Workflow Visibility
Give your administrative and billing teams a clearer view of which requests need attention and which have recorded review outcomes.
Support More Consistent Follow-Up
Maintain organized records of submission information, affirmation decisions, and non-affirmation details so staff can determine their next steps.
Work Within Your Existing EMR
Manage RCD-related documentation and tracking within Finale Health, alongside the patient records your agency already uses.
The Review Choice Demonstration (RCD) is a Medicare program administered by the Centers for Medicare & Medicaid Services (CMS). It allows participating home health agencies to select from applicable review options, including pre-claim review and post payment review.
Finale Health provides tools for organizing pre-claim review documentation, preparing supporting packets, recording submission details, and tracking review decisions. This helps agencies maintain clearer records throughout the administrative workflow.
Yes. The demonstrated RCD Tracking workflow allows users to select available patient documents, including plans of care, physician orders, OASIS assessments, and other relevant supporting records.
Finale Health allows users to record review outcomes, including affirmation details and reasons for non-affirmation, helping teams identify requests requiring further attention.
No. Finale Health helps agencies organize and track their RCD workflow. Agencies remain responsible for submitting requests through the appropriate Medicare review channel and following applicable CMS and Medicare Administrative Contractor requirements.
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