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American overview m_ds_psychiatrists_march_1,_2010
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American overview m_ds_psychiatrists_march_1,_2010

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These service's are provided by Psyciatrists, Social Workers and Psycologists and other Mental Health care providers

These service's are provided by Psyciatrists, Social Workers and Psycologists and other Mental Health care providers

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  • New expensive meds. SNFs lose money on every patient. Unfunded Trauma patients.

American overview m_ds_psychiatrists_march_1,_2010 American overview m_ds_psychiatrists_march_1,_2010 Presentation Transcript

  • American Innovative Healthcare Solutions LLC Psychiatric Care & Fall Prevention Value Driven Regulatory Compliant
  • Presentation Overview
    • Who is American Innovative Solutions? 3-5
    • Targeted Populations. 6
    • Continuum of Care. 7
    • Advantages for Psychiatrists. 8
    • Advantages to Nursing Homes. 9
    • Professional Disciplines. 10
    • Physician Functions. 11
    • Casework Functions. 12
    • Admission/Discharge Planning Functions. 13
    • Next Steps. 14
    • Contact Information. 15
  • Values
    • Compassion
    • Excellence
    • Partnership
    • Innovation
  • Principles of our Philosophy
    • Respect and dignity.
    • Collaboration.
    • Concern for the whole person.
    • Address clinical, business, corporate and social-ethical issues.
    • Social responsibility to help underserved.
  • Cost Effectiveness comes from:
    • Removing obstacles to help patients.
    • Providing care under an outpatient for profit business model.
    • Innovative integration of billing and clinical services.
    • Uses Medicare fee for service and Part B billing.
    • Optimizing full time equivalent staff.
    • Using Contractors to expand services minimize over head.
    • Matching skill levels of staff to case mix.
    • Rapid Innovation/anticipation of regulatory changes.
    • Continuous Quality Improvement.
    • Using “ Experts ” for training. Optimizes resources of talent and time toward measurable training goals.
  • Targeted Populations
    • Inpatient Readmissions <30 days
    • Moderate-High Fall Risk
    • Children and Adolescents in Institutional Living
    • Severely Mentally Ill.
    • Medicare Funded
    • Dual Eligible
    • We serve Mentally ill patients living in extended care facilities.
    • Mentally ill living in group homes or shared apartments.
    • Newly Diagnosed conditions.
    • Mental status changes.
    • General functioning between 35-70 on the Global Assessment of Functioning scale or CGAS.
  • Developing a Continuum of Care
  • Advantages to Psychiatrists
    • Doctors focus on excellent patient care.
    • We provide support from Licensed Clinicians.
    • We provide Behavioral Health Assistants to locate patients.
    • We monitor and manage regulatory compliance issues.
    • We process and store patient charts.
    • Assist in Audit preparation.
    • Professional management of:
    • Billing and revenue collection.
    • Provider registration with Medicare and Medicaid.
    • Doctors receive income before providers pay claims.
    • Growing patient base of 1000+ children and adults.
    • Rapidly increasing Market Share.
    • Monitor and Anticipate Regulatory change.
  • Advantages to Nursing Homes
    • Easily integrates with standard admission orders sets.
    • We provide required patient treatment documentation.
    • We assess and/or treat qualifying psychiatric behaviors.
    • We treat patients on site.
    • Balance Testing provides data, MD interpretation & Recommendations.
    • We provide assessments and treatment under Medicare standards.
    • Patient documentation may qualify patients for additional reimbursement under the Medicaid Minimum Data Set.
    • We use Illinois Clinically Licensed professionals.
  • LCPC LCSW Behavioral Health Assistants M.D. Senior Leadership Professional Disciplines Psychiatrists
  • AIHS Physician Functions
    • Complete Assessments (Differential Diagnosis)
    • Appropriate level of care determination with medical necessity.
    • Authorize Treatment Plans.
    • Collaborate with primary care physicians.
    • Medication Management.
    • Interpret Balance Testing Data.
    • Provide “Incident to” supervision.
    • Provide individual therapy.
    • Use critical thinking to:
      • Compare treatment plan to efficacy based practices.
    • Function in a collaborative and supportive role with:
      • Facility social service directors.
      • Clinically Licensed staff.
      • Behavioral Health Assistants.
  • Case Work - Five Basic Functions
    • Utilization management
      • Level of care
      • Clinical resource usage
      • External payer certifications
    • Care Coordination
    • Admission/Discharge planning
    • Identification/management of other patient needs
      • Education
      • Psychosocial
      • Spiritual
      • Medical, Infection, risk management, quality of care issues
    • Outcomes measurement
      • Clinical
      • Satisfaction
      • Financial
    • Communication!
  • Admission/Discharge Planning Functions
    • Ensure assessment process
      • High-level screen and referrals, or
      • In-depth assessment for all patients.
    • Offer informed choice/respect patient rights.
    • 3. Communicate with facility nursing, social service staff, family members, power of attorney or guardian.
    • 4. Coordinate with the facility to coordinate relevant data to next level of care.
    • 5. Close the circle between nursing home and hospital.
  • Next Steps
    • Meet with Kelly Alcantar, at Patriot Finance
      • Completion of AIHS Management Services Agreement.
      • Medicare and Medicaid Provider packets.
      • Billing Agreement
    • Collaborate on timing for start up.
    • Begin treating residents/patients.
  • Contact Information
    • John M. Sellers, LCSW
    • Chief Clinical Officer
    • Cell Phone: 847-532-3580
    • [email_address]
    • Gordon Schweigerdt
    • President
    • Cell Phone: 847-456-8548
    • [email_address]
    • American Innovative Healthcare Solutions
    • 10 W. 35th Street, 11th Floor
    • Chicago, IL 60616
    • Main Number: 312-224-8075
    • Fax: 312-238-9782