Presentation hosted by Conventus outlining specific strategies for adapting to new quality-based payment plans to boost revenue and cash flow. Features Ron Sterling of Sterling Solutions
Coding & Billing Services for DME (Durable Medical Equipment), Prosthetics & ...GoTelecare
Overview of full range of medical coding & billing services for DME, Prosthetics & Orthotics provided by GoTelecare.
GoTelecare is a leading global provider of Business and Knowledge Process Outsourcing services in the US healthcare domain. We deliver proprietary technologies, workflow and business processes to cater to various medical billing & coding requirements of our clients. We specialize in turnkey Revenue Cycle Management services, Account Receivables collection & clean-up, DME / Prosthetics & Orthotics billing and provide a complete range of billing & coding services for pharmacies, physicians, hospitals, nursing homes, urgent care centers, drug rehab centers and more.
Complete Durable Medical Equipment (DME) Billing Guide | Sun KnowledgeMichael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
DME Billing - http://sunknowledge.com/dme-billing-services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge provides Cost-Effective Solutions in Durable Medical Equipment (DME) Billing & Collections.
Sun Knowledge has a highly capable team of DME billing experts who can make life easier for you from the very first day. With Sun Knowledge by your side, you can leave all your DME billing worries to expert care. Outsourcing your DME billing requirements to us will allow you and your staff to concentrate on marketing, growing and running business operations, rather than managing a billing and collections department.
The Sun Knowledge Advantage:
The process starts with entry of orders and ends when the account has zero balance. This includes conducting eligibility checks, obtaining authorization, creating sales orders, scheduling delivery, submitting claims, managing rejections and denials, and proactively following-up AR.
Highlights
~ Follow-up on incomplete prescription with physician’s office
~ Follow-up for document collection (diabetic verification forms, LMN, CMN etc.)
~ Error free patient entry
~ Error free sales order creation
~ 100% HIPAA compliance
~ Real time transaction audits
~ Primary and secondary insurance verification
~ Insurance verification for rental items
~ Obtaining authorizations & extending authorization
~ Open order audit and clean-up
~ CPAP user compliance tracking and counseling calls to non-compliant patients
~ Claims submission within 48 hours of receiving proof of delivery
~ Rejection follow-up within 24 hours
~ Tracking and follow-up of partial or incorrect payments
~ Denial management based on detailed analysis
~ Methodical and proactive AR follow-up
~ Timely payment posting to reflect accurate AR
~ Customized reporting
Get started today.
We provide complete end to end solutions for Health care providers and payers.
We have rich experience in Revenue cycle Management services.
We have a strong team of AAPC certified coders, Billing Specialists and Denial management team.
We are currently looking for partner in revenue share for the business they bring in or Vendor partner relationship.
Coding & Billing Services for DME (Durable Medical Equipment), Prosthetics & ...GoTelecare
Overview of full range of medical coding & billing services for DME, Prosthetics & Orthotics provided by GoTelecare.
GoTelecare is a leading global provider of Business and Knowledge Process Outsourcing services in the US healthcare domain. We deliver proprietary technologies, workflow and business processes to cater to various medical billing & coding requirements of our clients. We specialize in turnkey Revenue Cycle Management services, Account Receivables collection & clean-up, DME / Prosthetics & Orthotics billing and provide a complete range of billing & coding services for pharmacies, physicians, hospitals, nursing homes, urgent care centers, drug rehab centers and more.
Complete Durable Medical Equipment (DME) Billing Guide | Sun KnowledgeMichael Smith
Sun Knowledge – A Practice Management and Revenue Cycle Management Company.
Contact Details:
New York Office - 41 Madison Avenue, 25th Floor, NY 10010
Phone - +1 212-400-6100, Email - contact@sunknowledge.com
Website - www.sunknowledge.com
DME Billing - http://sunknowledge.com/dme-billing-services/
Facebook - https://www.facebook.com/SunKnowledge
Twitter - https://twitter.com/sunknowledge
LinkedIn - https://www.linkedin.com/company/sun-knowledge
Google plus - https://plus.google.com/+SunknowledgeInc
Sun Knowledge provides Cost-Effective Solutions in Durable Medical Equipment (DME) Billing & Collections.
Sun Knowledge has a highly capable team of DME billing experts who can make life easier for you from the very first day. With Sun Knowledge by your side, you can leave all your DME billing worries to expert care. Outsourcing your DME billing requirements to us will allow you and your staff to concentrate on marketing, growing and running business operations, rather than managing a billing and collections department.
The Sun Knowledge Advantage:
The process starts with entry of orders and ends when the account has zero balance. This includes conducting eligibility checks, obtaining authorization, creating sales orders, scheduling delivery, submitting claims, managing rejections and denials, and proactively following-up AR.
Highlights
~ Follow-up on incomplete prescription with physician’s office
~ Follow-up for document collection (diabetic verification forms, LMN, CMN etc.)
~ Error free patient entry
~ Error free sales order creation
~ 100% HIPAA compliance
~ Real time transaction audits
~ Primary and secondary insurance verification
~ Insurance verification for rental items
~ Obtaining authorizations & extending authorization
~ Open order audit and clean-up
~ CPAP user compliance tracking and counseling calls to non-compliant patients
~ Claims submission within 48 hours of receiving proof of delivery
~ Rejection follow-up within 24 hours
~ Tracking and follow-up of partial or incorrect payments
~ Denial management based on detailed analysis
~ Methodical and proactive AR follow-up
~ Timely payment posting to reflect accurate AR
~ Customized reporting
Get started today.
We provide complete end to end solutions for Health care providers and payers.
We have rich experience in Revenue cycle Management services.
We have a strong team of AAPC certified coders, Billing Specialists and Denial management team.
We are currently looking for partner in revenue share for the business they bring in or Vendor partner relationship.
You know medical billing is a crucial part of your private practice, but why exactly is it so vital? This presentation explains why medical billing is a matter of survival. Claims must be submitted in a timely manner in order for physicians to get paid for their services.
Looking for ways to maximize reimbursement? Interested in outsourcing your medical billing?
Visit Our Website: http://www.CaptureBilling.com/
We are a Professional Software Company specialized in delivering complete health care solutions for Hospitals, Nursing Homes, Multispeciality Centers, Diagnostic Centers and Pharmacy Shops. Practicing Medical Professionals & Domain Experts with specialized IT team, who have successfully computerized a large number of hospitals since a 6 year. The Software offered by us is a result of extensive efforts spent by a team of dedicated large group of Software Professionals under the guidance of Medical Experts for over 6+ years. We have installed our Software in over 300+ hospitals in India since 2007
Cardiology Coding Got You Down? Use These 5 Tips for Success!Manny Oliverez
Struggling with billing for your cardiology practice? In this presentation, we discuss 5 challenges to proper documentation and coding in a cardiology practice. These challenges include human errors, lack of knowledge regarding current coding and documentation standards, working and charting in multiple care environments, and/or not coding to the highest degree of specificity.
Visit Our Website: http://www.CaptureBilling.com/
Global Healthcare Resource is one of the best and pioneer Medical Billling Company. That provides medical billing, physician billing, outsource hospital and medical billing. Browse through us online for more details.
Revenue Cycle Management for DME Practices by Sun Knowledge Inc.Som Chaudhuri
Portfolio of services in Revenue Cycle Management for DME practices by Sun Knowledge, including Medical Billing and Coding, Prior Authorization, Eligibility Verification, Claims Submission, Accounts Receivable Management, Denial Management and more.
How a healthcare management system (hms) is improving hospitals and clinicsShelly Megan
Clinics and hospitals are already adopting new approaches to enhance the patient experience. They are modernizing their systems to boost efficiency and improve productivity.
Know More : https://www.linkedin.com/pulse/how-healthcare-management-system-hms-improving-parija-rangnekar-1d/
You know medical billing is a crucial part of your private practice, but why exactly is it so vital? This presentation explains why medical billing is a matter of survival. Claims must be submitted in a timely manner in order for physicians to get paid for their services.
Looking for ways to maximize reimbursement? Interested in outsourcing your medical billing?
Visit Our Website: http://www.CaptureBilling.com/
We are a Professional Software Company specialized in delivering complete health care solutions for Hospitals, Nursing Homes, Multispeciality Centers, Diagnostic Centers and Pharmacy Shops. Practicing Medical Professionals & Domain Experts with specialized IT team, who have successfully computerized a large number of hospitals since a 6 year. The Software offered by us is a result of extensive efforts spent by a team of dedicated large group of Software Professionals under the guidance of Medical Experts for over 6+ years. We have installed our Software in over 300+ hospitals in India since 2007
Cardiology Coding Got You Down? Use These 5 Tips for Success!Manny Oliverez
Struggling with billing for your cardiology practice? In this presentation, we discuss 5 challenges to proper documentation and coding in a cardiology practice. These challenges include human errors, lack of knowledge regarding current coding and documentation standards, working and charting in multiple care environments, and/or not coding to the highest degree of specificity.
Visit Our Website: http://www.CaptureBilling.com/
Global Healthcare Resource is one of the best and pioneer Medical Billling Company. That provides medical billing, physician billing, outsource hospital and medical billing. Browse through us online for more details.
Revenue Cycle Management for DME Practices by Sun Knowledge Inc.Som Chaudhuri
Portfolio of services in Revenue Cycle Management for DME practices by Sun Knowledge, including Medical Billing and Coding, Prior Authorization, Eligibility Verification, Claims Submission, Accounts Receivable Management, Denial Management and more.
How a healthcare management system (hms) is improving hospitals and clinicsShelly Megan
Clinics and hospitals are already adopting new approaches to enhance the patient experience. They are modernizing their systems to boost efficiency and improve productivity.
Know More : https://www.linkedin.com/pulse/how-healthcare-management-system-hms-improving-parija-rangnekar-1d/
Венера — вторая планета от Солнца, названа именем древней римской богини любви и красоты.
Венера — самая горячая планета в Солнечной системе и вторая от Солца, после Меркурия. Хотя Венера не является ближайшей к Солнцу планетой, однако ее плотная атмосфера так называемая, ловушка тепла, создает парниковый эффект, который также нагревает Землю. В результате этого, температура на Венере может достигать 870 градусов по Фаренгейту (465 градусов по Цельсию), что более чем достаточно, для того, чтобы расплавить горячий свинец.
Présentation du RC&D sur le bilan de la COP21rac_marion
Depuis plusieurs années, le Réseau Climat & Développement travaille à la préparation des négociations internationales sur le climat. En 2015, il s'est particulièrement investi dans la préparation de la COP21 qui s'est tenue à Paris du 30 novembre au 11 décembre 2015. Deux mois après cet évènement majeur, quel bilan peut-on tirer de la COP21 ? Quelles perspectives pour la suite ?
Provides an overview of the current revenue cycle management and its processes and offers a point-of-view on today’s RCM trends and areas of transformation.
We provide complete end to end solutions for Health care providers and payers.
We have rich experience in Revenue cycle Management services.
We have a strong team of AAPC certified coders, Billing Specialists and Denial management team.
We are currently looking for partner in revenue share for the business they bring in or Vendor partner relationship.
Founded in 2003, Nortec Software has established itself as a pioneer in Healthcare Information Technology. Since its inception, Nortec has kept abreast of the dynamic environment of the healthcare sector, providing quality and innovative solutions to its customers. After several years of consumer-conscious software development and testing, Nortec is proud to announce the availability of Nortec’s Electronic Health Record software to all practicing medical providers.
RPA (Robotic Process Automation) promises to automate various complex tasks for healthcare organizations – payers and providers – to improve member experience, lower costs and relieve employees from rising pressure of work. But when it comes to actual applications of RPA, most companies are having a difficult time. This brief eBook outlines the benefits, challenges, tools and key healthcare use cases of RPA that can help healthcare organizations boost their productivity.
Driving Value - Taking the Healthcare Revenue Cycle to the Next Level.pdfAGSHealth1
As hospitals and healthcare systems evolve to meet the needs of a growing and aging population, they find themselves struggling to remain financially healthy.
https://www.agshealth.com/blog/driving-value-taking-the-healthcare-revenue-cycle-to-the-next-level/
Telehealth and Medical Tourism platform that transforms healthcareArun Kumar
Health care sector is undergoing a critical transition from a delivery system aimed at providing occasional institutional care for the treatment of illnesses to an importance on information systems that support community-based care, with greater consumer involvement in the prevention and management of illness across the life span. Telemed is a Mobile Application Platform using advanced communications technologies to support long-distance Video Visits, Second opinions, Patient health education, Push Alerts, Health Analytics, Electronic health Records, and SOAP Notes
Similar to Strategies to Improve Practice Cashflow (20)
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
COVID-19 PCR tests remain a critical component of safe and responsible travel in 2024. They ensure compliance with international travel regulations, help detect and control the spread of new variants, protect vulnerable populations, and provide peace of mind. As we continue to navigate the complexities of global travel during the pandemic, PCR testing stands as a key measure to keep everyone safe and healthy. Whether you are planning a business trip, a family vacation, or an international adventure, incorporating PCR testing into your travel plans is a prudent and necessary step. Visit us at https://www.globaltravelclinics.com/
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
2. Sterling Solutions, Ltd.
Technical Assistance
Technical AssistanceTelephone Number:
732-822-9948
Question Submission for Q&A Session:
Type your question into the Questions drop down on your
screen.
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3. Sterling Solutions, Ltd.
Conventus Risk Management
Advances in Practice Operations Series
• “StreamliningYour Practice for Profitability & Success”
• “Revenue Cycle Management & EHRs”
• “Quality Driven Healthcare & EHRs”
• “Patient Flow & the Bottom Line”
Onsite Services
• C.A.R.E. Certification Program
• Office Risk Assessments
• EHR Risk Consultations
Conventus Practice Hotline – 24/7
Online Resource LibrariesOnline Resource Libraries
E-Technologies and Strategic Partnerships
FREE Online CME
E-Publications
4. Sterling Solutions, Ltd.
Today’s Expert
Ronald B. Sterling, CEO of Sterling Solutions, Ltd., is a
nationally-recognized thought leader on leveraging EHRs to
boost practice revenue through smart selection and
implementation of electronic health record and practice
management systems.
Ron has advised healthcare organizations and practices across
the country. Ron has analyzed software from over 150
vendors.
Ron publishes the popular EHR Blog,Avoid-EHR-
Disasters.com and authored the HIMSS Book of the Year
Award winning Keys to EHR/EHR Success - Selecting and
Implementing an Electronic Medical Record. Ron has
contributed hundreds of articles to a wide range of
publications including the widely used MarketingYour Clinical
Practice.
6. Sterling Solutions, Ltd.
RCM Focus Changes to
Support Evolving Payment Models
From -
E&M
Charge Capture
To -
Maintaining Quality and Performance
Patient Service
Proving Quality
Patient Centered Specialty Practice
Patient Centered Medical Home
7. Sterling Solutions, Ltd.
Issues that Influence RCM Strategy
Meaningful Use
HIPAA Security Standards
Accountable for Integrity
Assure Accessibility
ACA Effect
Higher Deductible
Health Insurance Exchanges
“Cloning” Records
8. Sterling Solutions, Ltd.
Preserve Information to Support RCM
Notes
New Service Documentation Tools
- Clinical Messaging
- Patient Remote Patient Monitoring Systems
Patient Quality and Service Objectives
- Coordinate Patient Populations
- Track Patient Care
Performance Standards
- Quality Improvement
8
RCM Support Is Complicated
9. Sterling Solutions, Ltd.
RCM Support Is Complicated
Payers/ACOs MayVary
Sustain an Audit of Supporting Documentation
Requests for Documents
Examination of EHR Based Records
- Computer Assisted Review Tools
- Review of Audit Trails
- Review Context of Care
9
10. Sterling Solutions, Ltd.
Evolving RCM is Complicated
EHR May Not Accommodate
Tracking of Key RCM Measures
Relevant Status Over Activities
May Require Changes to EHR Use
Activities Measures
Documentation toTrigger RCM Requirements
11. Sterling Solutions, Ltd.
May Require Additional Documentation
Meaningful Use Like Attestation
Global Reporting
Performance Tracking
Payment May Not Be Associated with a Patient
Quality Incentive
“SGR Fix” Payments
Evolving RCM is Complicated
12. Sterling Solutions, Ltd.
EHR Records areVulnerable
Payer Patient Service Expectations
First Response
Final Resolution/Recommendation
Due Diligence to Protect Patient Records
Avoid Degradation
Maintain Accuracy and Consistencyy
EHR Challenges Related to RCM
13. Sterling Solutions, Ltd.
EHR Challenges Related to RCM
ICD10 Starts October 1, 2015
Not Just About Coding
- Clinical Decision Support (MU)
- Health Maintenance Items
- Classification of Plans,Visits and More
ICD10 Specificity
- Site
- Laterality
- Visit Type
- More
14. Sterling Solutions, Ltd.
Clinical RCM Objectives
Verify Record Standards
Maintain Integrity of Patient Records
Protect Against
Unsubstantiated Services
Quality Lapses
Claim Fraud
Support Contractual, Professional and Industry Standards
15. Sterling Solutions, Ltd.
Agree on Operational Standards
Standards Based on
EHR Features
Product Use
Payer/ACO
Practice
Services
Doctors
16. Sterling Solutions, Ltd.
RCM Checklist Items
Notes Signed Within X Hours/Days
Regular OfficeVisits
eVisits
Evolving Activities (Ex.ACO Support)
EHR Interface with PMS/Billing
Accuracy
Timeliness
ICD9/10 Coding
Changes
Substantiation
18. Sterling Solutions, Ltd.
RCM Checklist Items
Patient Portal Traffic
Patient Submission of Information
- New Patients
- Follow Up
Turnaround Time
Follow Up on Undelivered Messages
Documentation Supports Care Standards
19. Sterling Solutions, Ltd.
EHRPatient Portal Patient Request
Response
Information
Messages – Sent to Inbox and Information Entered into EHR.
Information Accepted – Information Flagged and Posted to Patient Chart.
Patient Portal
20. Sterling Solutions, Ltd.
RCM Checklist Items
Outgoing and Incoming Electronic Traffic Check
Rx
Transition of Care
Lab Results
Patient Orders
Other Results
Workflow Management
Patient Appointments Cleared and Completed
To-dos and Messages Completed
21. Sterling Solutions, Ltd.
RCM Checklist Items
Internal Messaging
Part of Patient Service Strategy
Status and Response byType
Workflow Issues
Incoming Documents/Images
Status of Items to be Indexed
Routing of Indexed Items
Documentation of Decisions
Changes to Care Plan
Document Patient Notification
23. Sterling Solutions, Ltd.
RCM Checklist Items
Quality Patient Services
Test Results Follow Up
Procedure/Surgery Follow Up
Referral Follow Up
ReminderTransmission
Reminder Follow Up
Health Maintenance Items
Outstanding Orders
Obsolete Orders
24. Sterling Solutions, Ltd.
RCM Reporting
Maintain Statistics to Prove Performance
Payer
Patient Population
Provider
Location
Report on Standards
Performance
Trends
25. Sterling Solutions, Ltd.
Supporting Claims and Collections
In addition to copy of notes to match
E&M code with documentation….
Includes proving care standards
Depends on operational performance
Requires timely and accurate records
Meaningful Use reporting and Clinical
Quality Measures are a window into
the future of RCM
26. Sterling Solutions, Ltd.
RCM and EHR Cases
PMS receives charges for office visits from EHR but EHR does
not post transactions for patient advice, RPMS monitoring and
other activities that are billed/paid under a quality initiative.
What are the RCM issues?
What are the RCM problems in light of an ACO environment?
What is a workaround to maintain financial information?
27. Sterling Solutions, Ltd.
RCM and EHR Cases
Practice receives a quality incentive payment for
managing an at risk patient population. The PMS only
posts fee for service charges.
How and where should the payment be posted?
Can the payment be posted directly to the accounting system
and bypass the PMS?
How will realization reports be affected?
28. Sterling Solutions, Ltd.
RCM and EHR Cases
EHRVendor advises practice to not sign
patient notes in case the doctor wants to
change the document.
What are the fee for service issues?
What are the professional liability issues?
What are the RCM problems in light of an ACO
environment?
29. Sterling Solutions, Ltd.
RCM and EHR Cases
EHR Messages are not included as part of the
patient record according to the EHR design.
How does this design complicate quality patient
care?
What are the operational accommodations needed
to support quality care based RCM?
30. Sterling Solutions, Ltd.
Go Forward Plan
Monitor EHRVendor tools to
support RCM under evolving
payment and performance systems
Meaningful Use as a Start
Maintain EHR Documentation and
Performance Standards to take
advantage of EHR and align your
practice with evolving revenue
models (ACO, Shared Savings, PCSP,
etc.)