Physicians are integral to your success, and reimbursement reform is intensifying their role. Our dedicated physician services team includes professionals who help practices improve profitability via revenue cycle, operational and management reporting enhancements, improvement of internal controls and strategic partnering.
Strategic Planning & Positioning
Successful practices have clear, effective alignment strategies. Health care and reimbursement reform is rapidly changing how you deliver, document and collect on care. Our professionals help practices engage in disciplined strategic planning, strengthen governance and accountability structures and foster provider engagement.
We can help with:
- External alignment planning, process and execution
- Succession planning
- Compensation plan design and re-engineering
- Preparation for health care reform implications, including capitation readiness
- Structural reimbursement consulting
Compliance & Internal Controls
Keeping pace with evolving regulatory compliance requirements is tough, and building processes to capture and document compliance can be a challenging and vexing task. Our physician team has extensive experience in the regulatory realm and uses sophisticated analytics to clarify the complexity and implement continual process improvement concepts.
Key initiatives include:
- Fair market value and commercial reasonableness
- Compensation plan internal controls
- Large data analytics
- Contractual payment analysis
- Fraud investigation and prevention
Operations in Value-Based Environment
Value-based arrangements are becoming a higher percentage of total revenue, increasing the importance of developing the skills and protocols necessary for success. Providers are changing their approaches to capturing and reporting HCC codes, managing care across the continuum and responding to the quality and outcomes metrics.
Our team helps providers:
- Develop effective case management protocols to control episode costs for high-risk, high-expense patients
- Develop clinical protocols that target care variations and control episode costs
- Correct coding initiatives such as AWV process to properly reflect HCC scores
Improving revenue cycle processes and performance creates value beyond the financial boost. Frequently, these projects also result in improved compliance, an increase in departmental collaboration and efficiencies that can help save you time.
Our team can provide a detailed analysis of your processes, policies and practices, charge capture, claims submission, follow-up and denial management and compliance issues related to the revenue cycle. In addition, our team can help train your staff.
- Documenting Fair Market Value & Commercial Reasonableness - Strategies for Success
- Commercial Reasonableness Checklist
- Gainsharing: Developing Your Collaborator Agreements & Regulatory Waivers
- Physician Engagement in a Value-Based Reimbursement Environment Through Compensation Design
- Diagnosing Your Payments: What's Driving Your Value-Based Reimbursement?
- QPP Reporting Requirements Waived for Disaster Areas
- Don't Miss Proposed Updates to the 2018 QPP
- Understand the Value of Accurate CDI & Coding
Looking for meaningful educational opportunities? Our professionals are veteran trainers who routinely share their insights at industry-leading events. In addition to developing effective training programs tailored for your organizational goals, we’re able to offer a variety of continuing education credits. Start the conversation by submitting a Contact Us form below.