Accreditation and Regulatory Failures from PSV Non-Compliance

$10,000 - $30,000 monthly from Medicaid claim denials due to enrollment gaps; audit risk • $10,000 - $30,000 monthly in VA claim denials; loss of VA provider contract if PSV failures identified • $10,000-$18,000 per duplicate billing incident; accreditation risk if Joint Commission audit finds consolidated billing errors; annual loss: $400,000-$900,000

Administrator relies on manual compliance reports from Admissions and Billing; annual JOINT Commission self-assessment using paper checklists; reactive remediation only after survey citations • Admission paperwork review, verbal confirmation calls, manual entry into billing system, credit card on file collection • Admissions Director manually maintains list of hospital relationships; phone calls to hospital compliance teams to verify credentialing; paper-based referral arrangement documentation; no centralized tracking of ongoing hospital partner credential status