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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

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American overview m_ds_psychiatrists_march_1,_2010

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

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