Consulting
Reimbursement rules change by the hour, so you need to ensure your organization is up to date and on track. Our team of experts brings years of regulatory and operational experience to the table.
Education for change. Assessing for opportunities. Monitoring for risk.
Our areas of specialty include:
Audits and assessments
Detect and correct errors usage for accurate reimbursement.
- Inpatient services: A wide range of topics, including MS-DRG review, modifier usage and more
- Outpatient services: Your most challenging specialties, including injections and infusions
- E/M audit and review: Ensure appropriate leveling and documentation for professional and facility services
- Audits of RAC-identified errors: Detect and correct coding errors on challenging areas prone to RAC scrutiny.
- Practice operations assessments: A comprehensive audit and review including operations manual and training.
Watchdog advisory and monitoring services
Providers and payers alike have to stay on top of a regulatory environment that is constantly evolving. You can accomplish that with alerts, analysis and ongoing access to our consulting faculty. It’s a powerful solution to the demands created by changes in reimbursement regulation.
- Weekly analysis of new regulations, news and transmittals from CMS
- Monthly customized newsletter ranking CMS notifications by priority and implication to your organization
- Monthly conference calls with an HCPro regulatory specialist to talk through the email newsletter, providing analysis, operational guidance and the ability to provide answers to your pressing questions
- Optional on-call research
- Optional on-call consulting Q&A
Custom education
- Observation and one-day stay review: Know the rules of engagement to ensure compliant use of patient status.
- RAC education: We can demystify the RAC program for your physicians, case management team, coding staff and more.
- E/M training: Our faculty is expert at teaching physicians about the intricacies of E/M coding and how it relates to compliant, accurate reimbursement.
For more information about our services, fill out the form below:
MedicareFind™ is a Web-based regulatory database that allows users to easily and intuitively access Medicare reimbursement rules and regulations.
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Medicare Appeals: Overturn RAC Denials Using the Medicare Appeal Process
Find out how to manage the time frame for appealing denials, as well as how to track submitted appeals and learn techniques on how to efficiently appeal a denied claim, while keeping an eye on the changes the RAC permanent program is bringing.
