Physician-Centric Revenue Cycle Management Company Cathy Steadman Director of Business Development
Meeting Agenda <ul><li>MDeverywhere Overview </li></ul><ul><li>Interfaces and Workflow  </li></ul><ul><li>Methods to Incre...
About MDeverywhere <ul><li>MDeverywhere mission: Increase your revenue </li></ul><ul><li>Founded 1995, 500+ Employees </li...
Interfaces and Workflow Schedule Register Web / Handheld Charge Capture PRACTICE MDeverywhere Solution Submit Claims Post ...
The MDeverywhere Difference We will increase revenue 5% to 15% Automate Eligibility Decrease Denials by 90% Enforce Payer ...
How We Increase Revenue: 1. Rules Engine Reduces Denials 90% <ul><li>Handheld & web-based charge capture delivering rules ...
How We Increase Revenue: 2. PQRI & E-Prescribing Rules = 4.0% Bonus <ul><li>Physician Quality Reporting Initiative (PQRI) ...
How We Increase Revenue: 3. Payor Contract Compliance <ul><li>Commercial payors underpay claims by 7% </li></ul><ul><ul><l...
Payor Contract Compliance Identify Underpayments
Payor Contract Compliance  Appeal All Underpayments
How We Increase Revenue: 4. Eligibility Decreases Denials
How We Increase Revenue: 5. Increase Patient Volume <ul><li>Patient marketing and recall plan </li></ul><ul><ul><li>Review...
<ul><li>Our Web Based Practice Management Software offers Improved Visibility, Transparency and a Streamlined Workflow </l...
Administrative Benefits: Patient Ledger
Administrative Benefits: Workflow Tracking
Administrative Benefits: Patient Accounts Receivable
Administrative Benefits: Management Reports <ul><li>Insurance Aging Summary </li></ul><ul><li>Insurance Aging Detail </li>...
Net Collection Report: Our Report Card Charges by date of service Payments tie back to date of service Money we are not al...
Denial Summary Report
Our Start Up Process <ul><li>No software license fees </li></ul><ul><li>No maintenance or support fees </li></ul><ul><li>N...
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  • Slide 5: MDeverywhere Difference Now let me tell you why MDE is different, and how we can increase your revenue from 5-15%. I’m going to read through these slides quickly and then we’ll look at each one in more detail. Our automated eligibility system reduces your benefit related denials; Our rules engine that will reduce your denials by 90%; The rules engine also supports PQRI which will make you eligible for the 2% Medicare bonus; Payors are underpaying claims by 7% - 11% - our payor contract compliance software will catch these payment errors and drive your revenue up; and finally our patient outreach services will increase your practice volume. Now let’s go into each one of these areas in detail. How do you currently check eligibility? So you are checking one at a time, going to the web sites, making calls, etc.
  • Md Everywhere Pp Presentation Hospital

    1. 1. Physician-Centric Revenue Cycle Management Company Cathy Steadman Director of Business Development
    2. 2. Meeting Agenda <ul><li>MDeverywhere Overview </li></ul><ul><li>Interfaces and Workflow </li></ul><ul><li>Methods to Increase Revenue </li></ul><ul><li>Increased Visibility and Control </li></ul><ul><li>Start-up Process and Pricing </li></ul><ul><li>Schedule next steps </li></ul><ul><li>Email overview of our solution </li></ul>
    3. 3. About MDeverywhere <ul><li>MDeverywhere mission: Increase your revenue </li></ul><ul><li>Founded 1995, 500+ Employees </li></ul><ul><li>Currently Serving: </li></ul><ul><ul><li>3,200 physicians nationwide </li></ul></ul><ul><ul><li>Over 60 different specialties </li></ul></ul><ul><ul><li>Group practices, faculty practices, hospital departments </li></ul></ul>
    4. 4. Interfaces and Workflow Schedule Register Web / Handheld Charge Capture PRACTICE MDeverywhere Solution Submit Claims Post Payments Appeal Denials Work AR MDEVERYWHERE Back-Office MDe System Document Encounter Enter Codes (Optional) PRACTICE EMR Interface Demos Schedule Interface CPT & ICD Radiology: Dictations EKG: Encounter Data ER: Encounter Data Pathology: Encounter Data HOSPITAL DEPARTMENTS Interface Notes CPT & ICD Register Patients HOSPITAL SYSTEM ADT Interface Demographics Quest, Sunrise, LabCorp LABS Interface Demos
    5. 5. The MDeverywhere Difference We will increase revenue 5% to 15% Automate Eligibility Decrease Denials by 90% Enforce Payer Contracts Increase Patient Volume Visibility & Control Earn PQRI & ePrescribing Bonus
    6. 6. How We Increase Revenue: 1. Rules Engine Reduces Denials 90% <ul><li>Handheld & web-based charge capture delivering rules at point-of-care </li></ul><ul><ul><li>15 Million pre-defined Payor Specific rules including: </li></ul></ul><ul><ul><li>Additional rules built based on your denials = System Gets Smarter </li></ul></ul><ul><li>Incorrect Diagnosis Code </li></ul><ul><li>Bundling/Unbundling </li></ul><ul><li>Missing Modifiers </li></ul><ul><li>PQRI & E-Prescribe Measures </li></ul><ul><li>Invalid Referring Physician </li></ul><ul><li>Global Period Edits </li></ul>
    7. 7. How We Increase Revenue: 2. PQRI & E-Prescribing Rules = 4.0% Bonus <ul><li>Physician Quality Reporting Initiative (PQRI) </li></ul><ul><ul><li>Rules engine supports the current PQRI quality measures </li></ul></ul><ul><ul><li>If a patient is eligible our rules engine automatically enters PQRI procedure codes </li></ul></ul><ul><ul><li>Result: 2.0% Medicare bonus </li></ul></ul><ul><li>E-Prescribing rules will earn you the 2.0% Medicare bonus </li></ul>
    8. 8. How We Increase Revenue: 3. Payor Contract Compliance <ul><li>Commercial payors underpay claims by 7% </li></ul><ul><ul><li>We build a knowledge base with your payor contracts and payment rules (multiple surgery reduction, etc.) </li></ul></ul><ul><ul><ul><li>We know what you are supposed to be paid on every claim </li></ul></ul></ul><ul><ul><li>Appeal every claim where the payment is less than the contracted amount </li></ul></ul>
    9. 9. Payor Contract Compliance Identify Underpayments
    10. 10. Payor Contract Compliance Appeal All Underpayments
    11. 11. How We Increase Revenue: 4. Eligibility Decreases Denials
    12. 12. How We Increase Revenue: 5. Increase Patient Volume <ul><li>Patient marketing and recall plan </li></ul><ul><ul><li>Review current patient database and set patients up on recall plans (Annual visits, preventative exams, etc.) </li></ul></ul><ul><li>Reduce patient no show rate </li></ul><ul><ul><li>Appointment reminder system calls patients to remind them of upcoming appointments </li></ul></ul><ul><li>Referring physician communication </li></ul><ul><ul><li>Customized fax sent automatically to referring physician when a patient is admitted to and discharged from the hospital </li></ul></ul>
    13. 13. <ul><li>Our Web Based Practice Management Software offers Improved Visibility, Transparency and a Streamlined Workflow </li></ul><ul><ul><li>Patient Ledgers </li></ul></ul><ul><ul><li>Batch Status </li></ul></ul><ul><ul><li>Patient Accounts Receivable </li></ul></ul><ul><ul><li>Management Reports </li></ul></ul>Administrative Benefits: Visibility
    14. 14. Administrative Benefits: Patient Ledger
    15. 15. Administrative Benefits: Workflow Tracking
    16. 16. Administrative Benefits: Patient Accounts Receivable
    17. 17. Administrative Benefits: Management Reports <ul><li>Insurance Aging Summary </li></ul><ul><li>Insurance Aging Detail </li></ul><ul><li>Patient Aging Summary </li></ul><ul><li>Patient Aging Detail </li></ul><ul><li>Charge, Payment & Adjustment Summary </li></ul><ul><li>Procedure Analysis </li></ul><ul><li>Denial Summary </li></ul><ul><li>Denial Detail </li></ul><ul><li>Net Collection </li></ul><ul><li>Executive Summary </li></ul><ul><li>Payor Mix </li></ul><ul><li>Web based reports by doctor and department are available to different users based on their access level </li></ul><ul><li>MDeverywhere can also create custom reports for your practice </li></ul>
    18. 18. Net Collection Report: Our Report Card Charges by date of service Payments tie back to date of service Money we are not allowed to collect Professional discount Bad Debt Net Collections % = (Payments) / (Charges – Contractual Write-offs – Discretionary Write-offs)
    19. 19. Denial Summary Report
    20. 20. Our Start Up Process <ul><li>No software license fees </li></ul><ul><li>No maintenance or support fees </li></ul><ul><li>No interface, training or conversion fees </li></ul><ul><li>Deposit equal to one month of service is refunded to client after start-up </li></ul><ul><li>We get paid a percent of collection </li></ul><ul><li>Implementation Time: 8 - 12 weeks </li></ul>
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