|MedBridge Medical Solution's approach consists of three critical components:
A critical analysis of the entire current reimbursement process is performed. This is used to identify flaws and weaknesses in the existing organizational structure and to determine financial and legal impacts to the organization. The analysis includes the following components:
- Implementation of Support Services
A thorough evaluation of the reimbursement process is conducted through interviews with administrative and billing staff. Any revisions recommended are carefully designed to increase your organizations efficiency and maximize effectiveness.
- Reimbursement Operational Review
- Coding, Documentation and Reimbursement Review
- Encounter Form, Superbill Review
- Pricing Strategy
- Comparative Utilization Reports
- Reimbursement Operational Effectiveness
Coding, Documentation and Reimbursement Review
A focused audit of patient records, documentation, encounter form and explanation of benefits will be reviewed. This evaluation will consist of comparing documentation found in the patient's medical record to the CPT and ICD-10-CM codes billed, and evaluation of the corresponding explanation of benefits to determine the impact of all errors encountered.
Encounter Form Evaluation
A review of the current encounter forms/charge tickets/super bills used by your practice' typical case mix will be conducted. Recommendations will focus on formatting, accuracy of codes and or/descriptions assigned and be made based on the correct coding initiative. This project includes a detailed report of findings and recommendations.
Comparative Utilization Reports
This analysis compares your practice's current utilization patterns to the national productivity data, helping to identify possible areas of over utilized services. We can also identify under coded, over coded or incorrect coding services. Areas of compliance which may expose the practice to risk of potential carrier audit may also be revealed
B. EDUCATION AND TRAINING
Practice education is key to ensure the appropriate level of knowledge, understanding and accountability in the reimbursement process. This is accomplished by:
- Detailed Report Analysis
- Follow up meeting with individual physician
- Detailed Report Summary
- Customized Training Sessions
- Implementation Support
Once the information is gathered and processed a detailed physician analysis and report will be compiled outlining areas where reimbursement could be optimized and/or where noncompliance with Medicare and other payers exists will be prepared. This report will discuss finding regarding individual physician and practice. Included in the report is an implementation plan for compliance and correct coding with recommendations for improvement.
Customized Training Sessions
Training of physicians and staff is vital to maintain and reach your compliance goals. Training may be conducted in variety of ways ranging from one on one training sessions to lectures to larger groups. These sessions may be geared to an audience of physicians, coding and billing staff, or a combination of both. Typically included in the training session is reference material which attendees may take back to the office for implementation purposes. Our material is customized to your needs and quite detailed.
C. IMPLEMENTATION SUPPORT SERVICES
On-going implementation support to insure that the reimbursement process is managed efficiently using appropriate policies, procedures, and resources within the organization is available. This support is provided in the following ways:
- Update of Coding and Reimbursement Policies
- Concurrent Coding Service
- Training Products
- Ongoing phone and fax support
- Additional Training
- On-site or at our Training Facility