coding and compliance

• Increase understanding of CPT and ICD-9-CM methodology: Gain insight into payer interpretations, stay ahead of annual revisions, avoid using inaccurate or unspecified codes, and support medical necessity for services provided.
• Develop a strong, seamless documentation system: Strengthen knowledge of coding and documentation guidelines and requirements to ensure services are properly billed, the scope of encounters is appropriately portrayed, and the need for continuing care and diagnostic studies is demonstrated.
• Heighten awareness of utilization and production: Gain familiarity with CMS E/M specialty norms and monitor provider utilization patterns.
• Enhance compliance awareness: Gain insight into rules and regulations, develop internal compliance initiatives, and implement a plan to detect and correct billing improprieties.
• Optimize the fee schedule: Understand “relativity” of fees and be cognitive of the market. Calculate physician productivity based on RVU patterns.
• Achieve peak performance: Educate and mentor physicians and staff, classes to prepare coders for certification, review the reviewer, implement consistent and effective operational policies and procedures, analyze and design forms, assist providers in selecting appropriate E/M services, enhance revenue capture for ancillary services, and provide ongoing support.

business operations

• Improve business performance: Evaluate effectiveness of internal controls, implement best practices, create performance indicators, improve accounts receivable management, provide practice assessment, and analyze staffing requirements and allocation.
• Enhance financial performance: Provide analysis, benchmarking, financial indicators, and other tools.
• Improve physician productivity: Explore compensation design, impact of employment agreements including buy/sell terms, and productivity analysis.
• Strengthen physician leadership: Provide customized physician mentoring and education on financial and operational activities.
• Design, implement and execute strategies: Lead the organization through Balanced Scorecard methodologies, strategic planning, and business plan creation.
• Enhance reimbursement and increase understanding of managed care contracting: Effectively monitor charges submitted and reimbursement received, maintain awareness of contractual reimbursement levels, and impact of contractual arrangements.
• Enhance revenue management: Provide revenue cycle assessment and analyze clinical specialty mix and ancillary revenue.
• Improve organizational design structure effectiveness: Review current design and offer suggestions to strengthen organization structure