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Consulting Services

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Consulting Services

  • Process Improvement:
    • Workflow Optimization: Assess and refine billing and revenue cycle processes to enhance efficiency and reduce errors.
    • Automation Consulting: Implement tools for automating repetitive tasks to reduce manual errors.
    • Operational Assessments: Conduct comprehensive reviews of billing operations to identify areas for improvement.
  • Training and Education:
    • Billing and Coding Training: Provide training sessions for staff on billing practices, coding accuracy, and regulatory changes.
    • Compliance Training: Educate staff on compliance with HIPAA, Medicare, Medicaid, and other regulations.
    • Insurance Carrier Policies: Train staff on specific requirements and policies of various insurance carriers to minimize denials.
  • Insurance Audits and Compliance:
    • Insurance Carrier Audits: Conduct audits of claims to ensure accuracy and compliance with payer guidelines.
    • Internal Compliance Audits: Regularly audit internal processes for adherence to industry standards and regulations.
    • Audit Support and Defense: Assist in preparing for and responding to insurance or governmental audits.
  • Claim Prepayment Review:
    • Prepayment Claim Audits: Review claims before submission to ensure they meet all criteria, reducing denials.
    • Compliance Reviews: Conduct thorough reviews of claims for compliance with payer policies before submission.
    • Quality Assurance: Implement quality checks for coding and documentation to ensure accuracy before claim submission.
  • Financial and Performance Reporting:
    • Revenue Cycle Analysis: Offer detailed reports on revenue cycle performance, identifying trends and bottlenecks.
    • Profitability Consulting: Assess profitability by service line, payer, or provider to optimize pricing strategies.
    • KPI Monitoring: Develop and monitor key performance indicators to improve billing efficiency.
  • Insurance Policy Consulting:
    • Contract Negotiation: Assist in negotiating favorable terms with insurance companies, including reimbursement rates.
    • Policy Review: Analyze insurance policies to ensure they align with the provider’s financial goals.
    • Payer Mix Optimization: Provide strategies to optimize the payer mix to improve revenue.
  • Denial Management Strategy:
    • Denial Trend Analysis: Identify common reasons for denials and implement corrective actions.
    • Appeals Management: Develop effective strategies for appealing denied claims to maximize reimbursement.
    • Root Cause Analysis: Perform analysis of denials and underpayments to prevent future issues.
  • Risk Management Consulting:
    • Risk Assessment: Evaluate potential risks in billing practices and offer strategies to mitigate them.
    • Compliance Risk Consulting: Minimize risks associated with regulatory compliance, including audits and penalties.

On-Site Operational Assessment

looks at all of the business processes from medical records and office computerization to marketing and office policies to determine if the practice is operating as effectively and efficiently as possible to optimize profits on practice income.

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Financial Performance Monitoring

is an ideal and inexpensive way to keep track of the financial performance of the practice on a monthly or quarterly basis. We do the work of reviewing the key financial indicators and condensing those data into a concise and useful report that we review with you.

Coaching and Development Programs

are designed to support the physician/owner with staff development, or with coaching an administrator or practice manager.

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