Auditing/Recovery Capture

Clients warrant our services to performance audit trails to validate: Quality Assurance, Quality Improvement.  We assess what happen – is the expectation of what was suppose to happen.

Each Client has different auditing needs and requirements.  We customize a specific package based on:

• Initial Intake Assessment

• Auditing Assessment

• Key Metrics of Concern

• Negotiated Terms

Medical Coding Assignment

From major Hospital Organization → to Boutique Concierge Clinics→ University Student Wellness Centers → to FQHC (Indigent Care).  We provide services to Government and Private sectors related to processing/auditing medical claims. 

We can assign the medical codes for: the diagnosis (ICD) – O/P (Out-patient) services, PCS (new I/P coding system since implementation of ICD-10), Procedures (CPT), Professional Fees for the Providers, Facility, & DME (Durable Medical Equipment).

Risk Management

Our industry is now structured more towards VBR (Value-Base Reimbursement).  Per CMS HEDIS measures are linked to reimbursement. These scores can make a difference in reimbursement.  Many of our team members have a comprehensive background – including working as a Clinician and leadership roles.

Telemedicine/Telehealth

With newly updated mandates, there are now (more than ever) new opportunities for Telemedicine reimbursement.

Billing

Billing is a specific services most of our Clients prefer to perform themselves.  But we also can process the billing component as well as the medical coding assignment portion.  Our team has experience working with various Practice Management Systems, to help process the Billing.

Reconciliation

This is another area of expectation that may differ from Client-to-Client. We can determine a reconciliation based on various reports and reports from the operation. 

Consulting

Most Healthcare Organizations nationwide struggle with the same concerns that are causing an outstanding A/R, so we share our experiential knowledge in working with others in the healthcare community.  We work with our of Clients as a Team to: identifying specific areas of concern and reconstituting new processes.

Transcription

Transcription of Medical Records, Telemedicine services, interrogation from devices that needs a typed report, and any other Healthcare Finance/Revenue Cycle Management related concerns.