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Mdeverywhere\'s solution for Hospitalists
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Mdeverywhere\'s solution for Hospitalists

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  • 1. Physician-Centric Revenue Cycle Management Company Cathy Steadman Director of Business Development
  • 2. About MDeverywhere
    • MDeverywhere’s mission is simple – to increase your practice revenue
      • Our product is a paid claim
    • Founded 1995, 500+ Employees
    • Currently Serving:
      • 3,200 physicians nationwide
      • Over 60 different specialties
      • Group practices, faculty practices, hospital departments
  • 3. Interfaces and Workflow Register Patients HOSPITAL SYSTEM Web / Handheld Charge Capture MDEVERYWHERE Charge Capture ADT Interface Demographics Submit Claims Post Payments Appeal Denials Work AR MDEVERYWHERE Back-Office
  • 4. The MDeverywhere Difference Eliminate Lost Encounters & Reduce Days to Billing Decrease Denials by 90% Enforce Payer Contracts Earn PQRI Bonus Visibility & Control We will increase revenue 5% to 15%
  • 5. How We Increase Revenue: 1. Rules Engine Reduces Denials 90%
    • Handheld & web-based charge capture delivering rules at point-of-care
      • 15 Million pre-defined Payor Specific rules including:
      • Additional rules built based on your denials = System Gets Smarter
    • Incorrect Diagnosis Code
    • Bundling/Unbundling
    • Missing Modifiers
    • PQRI Measures
    • Invalid Referring Physician
    • Global Period Edits
  • 6. How We Increase Revenue: 2. PQRI & E-Prescribing Rules = 4.0% Bonus
    • Physician Quality Reporting Initiative (PQRI)
      • Rules engine supports the current PQRI quality measures
      • If a patient is eligible our rules engine automatically enters PQRI procedure codes
      • Result: 2.0% Medicare bonus
    • E-Prescribing rules will earn you the 2.0% Medicare bonus
  • 7. How We Increase Revenue: 3. Eliminate Lost Charges & Reduce Days to Billing Actual Client Outcomes Reduced Days to Billing
  • 8. How We Increase Revenue: 4. Payor Contract Compliance
    • Commercial payors underpay claims by 7%
      • We build a knowledge base with your payor contracts and payment rules (multiple surgery reduction, etc.)
        • We know what you are supposed to be paid on every claim
      • Appeal every claim where the payment is less than the contracted amount
  • 9. Payor Contract Compliance Identify Underpayments
  • 10. Payor Contract Compliance Appeal All Underpayments
  • 11. How We Increase Revenue: 5. Referring Physician Communication
    • Fax sent automatically to referring physician when a patient is admitted to and discharged from the hospital
      • Customized fax includes patient name, diagnosis, procedures, admission (discharge) date and attending physician
  • 12.
    • Our Web Based Practice Management Software offers Improved Visibility, Transparency and a Streamlined Workflow
      • Patient Ledgers
      • Batch Status
      • Patient Accounts Receivable
      • Management Reports
    Administrative Benefits: Visibility
  • 13. Administrative Benefits: Patient Ledger
  • 14. Administrative Benefits: Workflow Tracking
  • 15. Administrative Benefits: Patient Accounts Receivable
  • 16. Administrative Benefits: Management Reports
    • Insurance Aging Summary
    • Insurance Aging Detail
    • Patient Aging Summary
    • Patient Aging Detail
    • Charge, Payment & Adjustment Summary
    • Procedure Analysis
    • Denial Summary
    • Denial Detail
    • Net Collection
    • Executive Summary
    • Payor Mix
    • Web based reports by doctor and department are available to different users based on their access level
    • MDeverywhere can also create custom reports for your practice
  • 17. 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)
  • 18. Denial Summary Report
  • 19. Our Start Up Process
    • No software license fees
    • No maintenance or support fees
    • No interface, training or conversion fees
    • Deposit equal to one month of service is refunded to client after start-up
    • We get paid a percent of collection
    • Implementation Time: 8 - 12 weeks

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