This document provides an overview of Wateridge Insurance Services' risk management and insurance brokerage program. It details Wateridge's company information, office locations, service team, coverage capabilities across various lines of insurance including property & casualty, workers' compensation, employee benefits, and risk services. It also outlines Wateridge's brokerage services, carriers represented, and workers' compensation programs and services.
Top 10 Medical Billing KPIs That Show Where Your Practice is Losing MoneyKareo
Kareo’s Billing Subject Matter Expert, Terri Joy, MBA, CPC, CGSC, COC, CPC-I, shares the 10 medical billing KPIs you need to know to prevent your practice from losing money.
Hiring an Initial Validation Auditor ACA RADV Commercial Risk Adjustmenthealthcareexcel
The partners you choose to prepare you for the ACA Commercial Risk Adjustment Audit are essential for determining your plan’s risk score and avoiding costly errors. Selecting your Initial Validation Auditor (IVA) is one of the most important aspects of preparing for Commercial Risk ACA RADV. These are 10 insights that should be considered when selecting an IVA firm.
Structuring Your Contracts for the Current ClimateKareo
Learn about the evolution of revenue cycle management and how to best structure your contracts now that patient responsibility is on the rise. Additionally, Aimee will walk through how to have tough conversations with clients when they are not being compliant.
Presented by Aimee Heckmann
The Bumpy Road Ahead New Challenges Facing PracticesCureMD
Insurance mergers, shift to alternative payment models, Meaningful Use stage 2, preventing data breaches, pressure to consolidate – welcome to 2016.
Your patience is not the only thing at stake when these changes kick in. Your hard earned money will become harder to collect and worse to retain. While we cannot wish these changes away, we can help you fight them.
Top 10 Medical Billing KPIs That Show Where Your Practice is Losing MoneyKareo
Kareo’s Billing Subject Matter Expert, Terri Joy, MBA, CPC, CGSC, COC, CPC-I, shares the 10 medical billing KPIs you need to know to prevent your practice from losing money.
Hiring an Initial Validation Auditor ACA RADV Commercial Risk Adjustmenthealthcareexcel
The partners you choose to prepare you for the ACA Commercial Risk Adjustment Audit are essential for determining your plan’s risk score and avoiding costly errors. Selecting your Initial Validation Auditor (IVA) is one of the most important aspects of preparing for Commercial Risk ACA RADV. These are 10 insights that should be considered when selecting an IVA firm.
Structuring Your Contracts for the Current ClimateKareo
Learn about the evolution of revenue cycle management and how to best structure your contracts now that patient responsibility is on the rise. Additionally, Aimee will walk through how to have tough conversations with clients when they are not being compliant.
Presented by Aimee Heckmann
The Bumpy Road Ahead New Challenges Facing PracticesCureMD
Insurance mergers, shift to alternative payment models, Meaningful Use stage 2, preventing data breaches, pressure to consolidate – welcome to 2016.
Your patience is not the only thing at stake when these changes kick in. Your hard earned money will become harder to collect and worse to retain. While we cannot wish these changes away, we can help you fight them.
Speaking before the Georgia Pediatric Practice Managers Association, PYA Consultant and ICD-10-CM Trainer Kim-Marie Walker addressed recent ICD-10 developments along with basic guidance for the transition, including:
• Comparison of ICD-9 and ICD-10
• ICD-10 organizational and structural differences
• Vendor recommendations and available resources
• Transition planning and roles
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
Eight strategies to get paid - Revenue Cycle ManagementJames Muir
Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
Hospitals and health systems are struggling to maximize the benefits of innovative technology to better manage uncompensated care and revenue integrity, suggests a HFMA/Navigant survey of 125 provider CFOs and revenue cycle management executives.
Healthcare Industry Highlight: Revenue Cycle ManagementCascadia_Capital
In our most recent Healthcare Industry Highlight Report on Revenue Cycle Management, we outline the trends driving consolidation and increased market activity and make predictions on the outlook and future of the RCM ecosystem.
Lean Strategies in Healthcare Revenue Cycle ManagementInvensis
Did you know? Revenue cycle inefficiencies accounted for 15% of 2.7 trillion spent on healthcare, or about $400 billion. Join Dr. Steven M Wagner to understand how to align continuous quality improvement through lean method for staff and management to overcome income obstacles in healthcare and help them to learn and experiment with strategies to address them.
The RAC's are coming: Is your medical practice prepared?sstgelais
Important notice to Medical providers/ Hospitals: starting in 2010, CMS (Medicare) has hired four RAC (Recovery Audit Contractors) to pursue claim billing violations. Their mission is to collect as many $$$ in overpayments as possible nationwide. They\\’re heavily incentivize (17% of what they collect). This presentation provides an overview of the RAC program as well as our baseline audit service to help protect you against the impending RACs
Learn how to be a RAC Survivor with Laura Legg, HRG Executive Director of Revenue Integrity and Compliance, in this thirty-three slide presentation. Get updated on the 2017 RAC Audit changes and what you can do to prevent a RAC attack.
For more info visit: http://www.hrgpros.com/rac-audit-optimization
hrgpros.com
@hrgpros
800.695.8171
Accounting Update Overview with a Healthcare SlantPYA, P.C.
PYA Principal and Director of Audit Services Doug Arnold presented during East Tennessee State University’s 38th Annual Accounting, Auditing, and Tax Updating CPE conference. His presentation covered many recent Accounting Standards Updates, but leaned toward their applications in healthcare.
Join HRG expert, Megan Smith, as she instructs on referrals & authorizations and clarifies the differences between the two. We review insurance benefit hierarchy and dive into coverage levels based on plan benefits. Megan discusses types of authorization denials and how to investigate them and shows tips on sending medical records when appealing a no-authorization denial.
What are the latest payment trends impacting the healthcare vertical? From electronic presentment and payment to mobile payments and beyond – what can we expect to see over the coming years?
Optimize Your Care Delivery to Prevent Burnout and Boost Your Bottom LineKareo
In this webinar, Dr. Paul DeChant will:
-Review the manifestations and drivers of burnout and how you can reduce their impact
-Help you develop a plan, including building teamwork and solutions to problem-solve
-Show you how to improve efficiencies through changes to EHR office visits and in-basket workflows
-Explore how using technology in your practice can save time and remove barriers to better connect with your patients
HIPAA & OIG Compliance for Medical Billing Company OwnersKareo
The success of your business relies on timely billing and accurate coding. Whether you’re managing the billing for one provider or 50, it’s a complex job that must meet a variety of regulations, making it easy for medical billing companies to be the target of false claims and fraudulent crimes. As healthcare fraud continues to be a growing issue in the industry, medical billers are increasingly being held liable for their role in the submission of fraudulent claims.
Executive Director of American Medical Billing Association, Cyndee Weston, CMRS, CMCS, CPC, will provide an in-depth analysis of what can be considered fraud when submitting medical claims, how the government is enforcing guidelines, and what you can do to help protect your business as well as your practices.
Speaking before the Georgia Pediatric Practice Managers Association, PYA Consultant and ICD-10-CM Trainer Kim-Marie Walker addressed recent ICD-10 developments along with basic guidance for the transition, including:
• Comparison of ICD-9 and ICD-10
• ICD-10 organizational and structural differences
• Vendor recommendations and available resources
• Transition planning and roles
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
Eight strategies to get paid - Revenue Cycle ManagementJames Muir
Join revenue cycle management expert Elizabeth Woodcock & James Muir to dissect the eight strategies for surviving and thriving in today’s turbulent reimbursement environment. This webinar will empower you with solutions to make your practice a top performer. In addition, attendees of this live webinar can quality for CEU credits.*
After this session, you’ll be able to:
Evaluate payer contracting opportunities and pitfalls
Determine contract management procedures to ensure appropriate payment
Implement effective methods of setting patient’s expectations for payment – before the visit
Apply time-of-service collections techniques
Develop denial prevention and management procedures
Assess technologies to support efficient revenue cycle management
Identify staffing needs for successful revenue cycle management
Differentiate the elements of reporting key performance indicators for revenue cycle management
Hospitals and health systems are struggling to maximize the benefits of innovative technology to better manage uncompensated care and revenue integrity, suggests a HFMA/Navigant survey of 125 provider CFOs and revenue cycle management executives.
Healthcare Industry Highlight: Revenue Cycle ManagementCascadia_Capital
In our most recent Healthcare Industry Highlight Report on Revenue Cycle Management, we outline the trends driving consolidation and increased market activity and make predictions on the outlook and future of the RCM ecosystem.
Lean Strategies in Healthcare Revenue Cycle ManagementInvensis
Did you know? Revenue cycle inefficiencies accounted for 15% of 2.7 trillion spent on healthcare, or about $400 billion. Join Dr. Steven M Wagner to understand how to align continuous quality improvement through lean method for staff and management to overcome income obstacles in healthcare and help them to learn and experiment with strategies to address them.
The RAC's are coming: Is your medical practice prepared?sstgelais
Important notice to Medical providers/ Hospitals: starting in 2010, CMS (Medicare) has hired four RAC (Recovery Audit Contractors) to pursue claim billing violations. Their mission is to collect as many $$$ in overpayments as possible nationwide. They\\’re heavily incentivize (17% of what they collect). This presentation provides an overview of the RAC program as well as our baseline audit service to help protect you against the impending RACs
Learn how to be a RAC Survivor with Laura Legg, HRG Executive Director of Revenue Integrity and Compliance, in this thirty-three slide presentation. Get updated on the 2017 RAC Audit changes and what you can do to prevent a RAC attack.
For more info visit: http://www.hrgpros.com/rac-audit-optimization
hrgpros.com
@hrgpros
800.695.8171
Accounting Update Overview with a Healthcare SlantPYA, P.C.
PYA Principal and Director of Audit Services Doug Arnold presented during East Tennessee State University’s 38th Annual Accounting, Auditing, and Tax Updating CPE conference. His presentation covered many recent Accounting Standards Updates, but leaned toward their applications in healthcare.
Join HRG expert, Megan Smith, as she instructs on referrals & authorizations and clarifies the differences between the two. We review insurance benefit hierarchy and dive into coverage levels based on plan benefits. Megan discusses types of authorization denials and how to investigate them and shows tips on sending medical records when appealing a no-authorization denial.
What are the latest payment trends impacting the healthcare vertical? From electronic presentment and payment to mobile payments and beyond – what can we expect to see over the coming years?
Optimize Your Care Delivery to Prevent Burnout and Boost Your Bottom LineKareo
In this webinar, Dr. Paul DeChant will:
-Review the manifestations and drivers of burnout and how you can reduce their impact
-Help you develop a plan, including building teamwork and solutions to problem-solve
-Show you how to improve efficiencies through changes to EHR office visits and in-basket workflows
-Explore how using technology in your practice can save time and remove barriers to better connect with your patients
HIPAA & OIG Compliance for Medical Billing Company OwnersKareo
The success of your business relies on timely billing and accurate coding. Whether you’re managing the billing for one provider or 50, it’s a complex job that must meet a variety of regulations, making it easy for medical billing companies to be the target of false claims and fraudulent crimes. As healthcare fraud continues to be a growing issue in the industry, medical billers are increasingly being held liable for their role in the submission of fraudulent claims.
Executive Director of American Medical Billing Association, Cyndee Weston, CMRS, CMCS, CPC, will provide an in-depth analysis of what can be considered fraud when submitting medical claims, how the government is enforcing guidelines, and what you can do to help protect your business as well as your practices.
Low-interest rates mean that P&C leadership teams are facing increasing pressure to generate heftier margins from their underwriting operations. More at http://gt-us.co/1japuAu
As physicians struggle with the need for medical billing reports, a small PPT on what medical billing reports every practice must pull up, in order to fix revenue leaks.
Presentation from the 2nd Annual Meeting for the Contractors Self-Insurance Trust Fund, providing workers' compensation insurance to New York State Contractors.
Revenue cycle management success: Learn these key factorsEyeCareLeaders1
Your ophthalmic practice should be leaning heavily on its revenue cycle management plan. RCM can help your practice minimize errors, increase the chances you will get paid, and tamp down on the size of your accounts receivable. https://eyecareleaders.com/revenue-cycle-management-success-factors/
The Insurance Act 2015 has introduced the most significant reform to insurance law in over 100 years. The Act impacts all those involved in the insurance sector. In this report we review key markets' response to the Act and outline the practical steps you should have addressed ahead of the Act coming into force.
Visit our hub to access information and resources tailored to brokers: www.brownejacobson.com/brokers
Revenue Cycle: Tracking Reimbursement for DRGs, APCs and MPFSAudioEducator
Review the reimbursement tracking as part of the revenue cycle, and understand the basics of DRGs, APCs and MPFS in this audio session with Duane Abbey.
46. Wateridge Carrier A Carrier B Carrier C Wholesaler B Wholesaler A Carrier D Carrier E Carrier F Carrier G Brokerage Services (Flow Chart) Wateridge continually creates competition in the marketplace so you will receive the best possible terms, conditions and pricing year after year. This process is always made 100% transparent to you from the start of the marketing process, thus eliminating the possibility of being “surprised” when the final proposal is presented.
57. Workers Compensation (Unit Statistical Report) What is the Unit Statistical Report? Six months prior to your renewal date of your workers’ compensation policy, your insurance carrier will send a “unit statistical report” to the WCIRB/NCCI which includes your audited payrolls and claim information for your organization. This data is used to determine your experience modification, which determines your premium for the next three years. What does Wateridge do for you? It is critical to review this information for accuracy using an independent experienced licensed claims adjuster and a professional premium auditor to be sure you are not over paying or wasting your hard earned profits. What most employers don’t know is that very few independent agents have access to these resources to do a professional review and to insure that you are not over paying for your workers’ compensation. Wateridge provides you with a hard copy “Unit Statistical Clearance Report” prior to your unit stat reporting date using seasoned claim adjusters and payroll auditors. We review all open claims for the past 3 years to determine if they can be closed or if the reserves can be lowered prior to the reporting date.
58. Workers Compensation(Aggravated Inequity Rule) What is the Aggravated Inequity Rule? Even if you attempt to close all claims prior to your unit statistical date, some claims simply can not be closed in time for various reasons. However, if they are closed prior to your renewal date and if your standard premium changes by more than 5%, you may qualify for the Aggravated Inequity Rule, allowing your carrier to re-file your unit statistical reports and lower your experience modification. This will lower your premium over the next three years. How does Wateridge use this rule to reduce your premiums? Wateridge provides you with a hard copy analysis of your experience modification including the aggravated inequity rule. If the analysis produces a reduction in your experience modification, Wateridge will contact your insurance carrier and WCIRB / NCCI to request a revised mod be calculated. Wateridge will then follow thru with the carrier to issue a return of premium check or audit credit on your account.
59. Workers Compensation(Profit Leak Audit) A common oversight of most employers is in not obtaining an in-depth analysis of their Workers’ Compensation program. Such analysis will expose “profit leaks” in current and past policy years, which not only are driving current and future costs, but also are areas of potential refunds. The Problem Most employers rely on their insurance carrier or agent to make sure they are maximizing their savings under the workers’ compensation system. The problem is that most agents are generalists and do not have a specialized professional staff to help manage your exposures properly. Sometimes the insurance carriers work load is too great to give your claims the appropriate time and attention needed. Over 70% of employers have profit leaks that may result in a premium refund! The Solution Wateridge offers a comprehensive “Profit Leak Audit” by our professionals. It can be done using only three documents and without interruptions of your carrier or current agent. -Complete trend analysis of all claims -Marketplace comparison of carriers -Experience modification analysis & recovery for 3 years -Current classification verification with WCIRB/NCCI -Audit analysis on payroll caps and overtime -Review of audit worksheets for accuracy -Salary in lieu of compensation analysis -Confirmation of 2% safety credit and 5% drug free workplace -Claim status report of all open claims -Claim frequency analysis -Review of medical only claims effect on mod -Aggravated inequity analysis -Credit vs. net deductible analysis -Dividend analysis -Renewal Positioning Strategy
60. Workers Compensation Performance Program Month 1 - Establish a customized industry specific risk management, loss control and other relevant documents - Introductory E-letter - Safety & Compliance Questionnaire Month 2 - Send letter on pre-audit tips Month 4 - Send post-audit letter to obtain audit worksheets and review if requested Month 5 - Complete Unit Stat Clearance Report – This is a review of open claims prior to submission for experience modification promulgation. Month 7 - Complete Experience mod book and review with client Month 12 - Review for Aggravated Inequities Rule - Aggravated inequity comes into effect when claims close after submission of the Unit Stat Cards prior to the policy renewal date, and causes a reduction in the standard premium of 5% or more. (FL, NC, MN, WI only) Month 18, 24 - follow-up
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64. Claim reviews with clients/carrier adjusters/agents on a regular basis
75. Review of final audits and billing for accuracy
76. Risk Solutions - HR and Risk Management Resources Many of our value-added services are extended to you electronically , Wateridge can set up personal Web site which will be set up for you immediately.