We solve financial, operational, and clinical challenges for acute and post acute providers.
Our expertise is guaranteed. Our solutions empower.
A HOLISTIC PERSPECTIVE
"We bring deep, focused expertise to address our clients’ most critical issues.
What sets us apart is our ability to see the big picture, across both the industry and the entire provider organization."
Marty Brutscher, CEO
McBee Associates
McBee Associates
We have been working with McBee Associates for more than 18 years on our bundled payment initiatives. Their system tracks profit and loss on a case level and establishes meaningful benchmarks so we can easily judge the success of our program. We feel confident knowing we have experts who understand the full continuum of care on our side for the CCJR model.
Trisha M. Frick-Hoff MS RN - Johns Hopkins HealthCare
Billing Services
From staff training to full outsource, we’ve got your billing needs covered.
Our account resolution specialists employ expert techniques so that you collect on difficult claims and keep cash flowing for your organization.
Advantages
• Consistent claim tracking and reporting
• Extensive systems experience
• Consultants are platform certified
• Experience with all Medicare, Medicaid, and commercial payers nationally
Related
Coding Services
Cash Acceleration
Interim Management
From staff training to full outsource, we’ve got your billing needs covered.
Our account resolution specialists employ expert techniques so that you collect on difficult claims and keep cash flowing for your organization.
Advantages
• Consistent claim tracking and reporting
• Extensive systems experience
• Consultants are platform certified
• Experience with all Medicare, Medicaid, and commercial payers nationally
Related
Coding Services Cash Acceleration Interim Management
Bundled Payment Solutions
To make the transition to bundled payments, we help you choose the right strategy, the right partners, and the right technology.
With a client base that spans the continuum of care, our insight into both acute and post-acute operations will position your organization to thrive under new models.
On the back end, our Bundled Payment System tracks profit and loss by case, keeping you informed on the performance of each function and partner.
Advantages
• 18+ years experience working with all bundled payment initiatives in health systems
• Intricate understanding of acute & post-acute operations
System Advantages
• Tracks cost data and profitability of services by any variable, including payer, physician, diagnosis, and post-acute provider
• Interfaces with billing systems
• Allows multiple fee schedules for physician payments
• Includes compliant general ledger reporting
Related
Revenue Cycle Process Improvement
Vendor Management System
White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care
To make the transition to bundled payments, we help you choose the right strategy, the right partners, and the right technology.
With a client base that spans the continuum of care, our insight into both acute and post-acute operations will position your organization to thrive under new models.
On the back end, our Bundled Payment System tracks profit and loss by case, keeping you informed on the performance of each function and partner.
Advantages
• 18+ years experience working with all bundled payment initiatives in health systems
• Intricate understanding of acute & post-acute operations
System Advantages
• Tracks cost data and profitability of services by any variable, including payer, physician, diagnosis, and post-acute provider
• Interfaces with billing systems
• Allows multiple fee schedules for physician payments
• Includes compliant general ledger reporting
Related
Revenue Cycle Process Improvement Vendor Management System White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care
Care Management Support
We help you get the patient status decision right the first time. To prevent denials and reduce the number of future appeals, our first-level reviews verify that documentation meets medical necessity criteria in real time.
Advantages
• Remote, first-level utilization review coverage any time: overnight, weekend, and holiday shifts
• Expert application of InterQual® and MCG® Guidelines
• Emergency department, inpatient, or PRN case review support options
• Case managers with an average of 15 plus years of experience
Related
Infographic: Four reasons why a fully staffed case management department is essential
Webinar: Return of the RACs: What It Means for Hospital Case Management and Finance
Denials and Appeals Management
We help you get the patient status decision right the first time. To prevent denials and reduce the number of future appeals, our first-level reviews verify that documentation meets medical necessity criteria in real time.
Advantages
• Remote, first-level utilization review coverage any time: overnight, weekend, and holiday shifts
• Expert application of InterQual® and MCG® Guidelines
• Emergency department, inpatient, or PRN case review support options
• Case managers with an average of 15 plus years of experience
Related
Infographic: Four reasons why a fully staffed case management department is essential Webinar: Return of the RACs: What It Means for Hospital Case Management and FinanceDenials and Appeals Management
Compliance & Internal Audit
Whether clinical, operational or financial, our systematic, disciplined approach to compliance is tailored to your specific goals. We know that the only way to truly minimize risk is by completely engraining compliance into an organization’s culture. By identifying trends and educating staff on resolutions and best practices, we make detailed recommendations to optimize your current processes and reduce risk.
Advantages
• Mock surveys to identify gap and risk assessment
• Quantitative audits to provide feedback on regulatory practices to show compliance
• Develop compliance plan to validate internal processes are complaint with industry regulations
• Conduct billing and reimbursement reviews that prepare organizations compliance with regulatory changes and updates
• Audit reviews & comprehensive findings of OIG requirements
• Education sessions that improve documentation to support medical necessity and process improvement initiatives
Related
Billing Services
Care Management
Denials & Appeals
Revenue Integrity
Whether clinical, operational or financial, our systematic, disciplined approach to compliance is tailored to your specific goals. We know that the only way to truly minimize risk is by completely engraining compliance into an organization’s culture. By identifying trends and educating staff on resolutions and best practices, we make detailed recommendations to optimize your current processes and reduce risk.
Advantages
• Mock surveys to identify gap and risk assessment
• Quantitative audits to provide feedback on regulatory practices to show compliance
• Develop compliance plan to validate internal processes are complaint with industry regulations
• Conduct billing and reimbursement reviews that prepare organizations compliance with regulatory changes and updates
• Audit reviews & comprehensive findings of OIG requirements
• Education sessions that improve documentation to support medical necessity and process improvement initiatives
Related
Billing Services Care Management Denials & Appeals Revenue Integrity
Denials & Appeals Management
We manage denials so you can focus on preventing them. We identify the root causes and craft compelling appeals that overturn denials incurred. Our case managers then provide recommendations to improve both the coding process and documentation to reduce denials over the long term.
Advantages
• Key metrics to categorize denial reasons and quantify financial impact
• Evidenced-based industry criteria cited to develop the most persuasive appeal letters
• Registered nurses and physician assistants with deep experience in patient care
• Staff has an average of more than 10 years of experience in diverse specialty areas
• Appeals to the ALJ level and beyond
Related
Case Management Support
Webinar: Return of the RACs: What It Means for Hospital Case Management and Finance - Recording
We manage denials so you can focus on preventing them. We identify the root causes and craft compelling appeals that overturn denials incurred. Our case managers then provide recommendations to improve both the coding process and documentation to reduce denials over the long term.
Advantages
• Key metrics to categorize denial reasons and quantify financial impact
• Evidenced-based industry criteria cited to develop the most persuasive appeal letters
• Registered nurses and physician assistants with deep experience in patient care
• Staff has an average of more than 10 years of experience in diverse specialty areas
• Appeals to the ALJ level and beyond
Related
Case Management Support Webinar: Return of the RACs: What It Means for Hospital Case Management and Finance - RecordingInterim Management
From chief financial officer to director of nursing positions, we serve in key leadership roles within finance and clinical operations across the care continuum. Our interim managers have the leadership experience to tailor their approach to your organization’s specific needs as well as the strategic vision to achieve clinical, financial, and operational goals.
Advantages
• Real-world leadership experience in acute and post-acute care settings
• Assistance in the recruiting process, guidance during the transition, and ongoing support as needed
• Available temporary staffing
• Experienced resources, including the expertise of the entire firm to achieve engagement goals
PACT Payment Recovery
To ensure your hospital receives proper payment on claims subject to the PACT policy, our validation and verification processes go beyond mere confirmation in the Medicare database. We confirm information directly with post-acute care providers to provide you the highest level of accuracy and adherence to compliance standards.
Advantages
• More than $60 million in payment recoveries to date
• Post-acute care visits confirmed directly with the provider
• We work with every major hospital information system.
• Fees are fully based on contingency of payment recoveries.
Revenue Cycle Improvement
For optimization of your current workflows or a financial turnaround, our consultants collaborate to design lasting solutions at any stage in the revenue cycle. We deliver a full range of services that address every area from patient intake to cash posting. The result is always a strategic process improvement that works in your organization.
Advantages
• Total revenue cycle assessment, operations re-engineering, and process improvement
• Management and expertise from financial leaders, policy analysts, and information technology specialists
• System implementation support
• Billing loan staff and training as needed
• Accounts receivable resolution and cash acceleration
Related
Interim Management
White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care
Webinar: Return of the RACs: What It Means for Hospital Case Management and Finance - Recording
For optimization of your current workflows or a financial turnaround, our consultants collaborate to design lasting solutions at any stage in the revenue cycle. We deliver a full range of services that address every area from patient intake to cash posting. The result is always a strategic process improvement that works in your organization.
Advantages
• Total revenue cycle assessment, operations re-engineering, and process improvement
• Management and expertise from financial leaders, policy analysts, and information technology specialists
• System implementation support
• Billing loan staff and training as needed
• Accounts receivable resolution and cash acceleration
Related
Interim Management White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care Webinar: Return of the RACs: What It Means for Hospital Case Management and Finance - Recording
Revenue Integrity
To realize and increase your revenue stream, we analyze historical data to assess current revenue processes and measure against regulations to design a strategy unique to your organization. From reviewing payer contracts and documentation in order to re-bill claims, to performing an in-depth assessment and implementing a strategic plan to improve annual revenues, we have a holistic approach to recover and increase future revenue opportunities.
Advantages
•Expertise in reimbursement systems and regulations
•Sustainable strategies to achieve significant increases in annually recurring net revenue
•Detailed analysis focused on payer population to optimize reimbursement
•Identify trends, educate staff, and make detailed recommendations
Related
Revenue Cycle Improvement
Interim Management
Billing Services
To realize and increase your revenue stream, we analyze historical data to assess current revenue processes and measure against regulations to design a strategy unique to your organization. From reviewing payer contracts and documentation in order to re-bill claims, to performing an in-depth assessment and implementing a strategic plan to improve annual revenues, we have a holistic approach to recover and increase future revenue opportunities.
Advantages
•Expertise in reimbursement systems and regulations
•Sustainable strategies to achieve significant increases in annually recurring net revenue
•Detailed analysis focused on payer population to optimize reimbursement
•Identify trends, educate staff, and make detailed recommendations
Related
Revenue Cycle Improvement Interim Management Billing Services
Vendor Management System
We simplify the process of managing outsourced collections. Our Vendor Management System automates the tracking of outsourced collection activities, making important information about your vendors available in mere keystrokes. Our customized dashboard tracks payments and multiple collection vendors, so that duplicate payments are a worry of the past.
Advantages
• Increased collections
• Prevent duplicate payments to multiple vendors
• Eliminate the need to manually validate vendor invoices
• Centralize inventory management for vendors within one system
• Confirm payments via cash posting
• Monitor and compare the performance of vendors
Related
Bundled Payment Solutions
Revenue Cycle Process Improvement
We simplify the process of managing outsourced collections. Our Vendor Management System automates the tracking of outsourced collection activities, making important information about your vendors available in mere keystrokes. Our customized dashboard tracks payments and multiple collection vendors, so that duplicate payments are a worry of the past.
Advantages
• Increased collections
• Prevent duplicate payments to multiple vendors
• Eliminate the need to manually validate vendor invoices
• Centralize inventory management for vendors within one system
• Confirm payments via cash posting
• Monitor and compare the performance of vendors
Related
Bundled Payment Solutions Revenue Cycle Process Improvement
ADR & Pre-Bill Services
Prevent reduced payments with a proactive strategy. Our clinicians respond to ADRs, craft winning appeals for denied claims, and review medical records to identify essential documentation needed to prevent future denials. The firm also offers pre-bill reviews with clinical feedback and recommendations for increased compliance and improved processes.
Advantages
• Clinical consulting group with more than 20 years of experience
• Well-crafted, winning appeals
• Proprietary software tool designed for pre-bill audits
• Pre-bill audits to improve billing quality in response to Medicare focused review
Related
Coding Services
Billing Services
Prevent reduced payments with a proactive strategy. Our clinicians respond to ADRs, craft winning appeals for denied claims, and review medical records to identify essential documentation needed to prevent future denials. The firm also offers pre-bill reviews with clinical feedback and recommendations for increased compliance and improved processes.
Advantages
• Clinical consulting group with more than 20 years of experience
• Well-crafted, winning appeals
• Proprietary software tool designed for pre-bill audits
• Pre-bill audits to improve billing quality in response to Medicare focused review
Related
Coding Services Billing Services
Billing Services
From staff training to full outsource, we’ve got your billing needs covered. Our account resolution specialists employ expert techniques so that you collect on difficult claims and keep cash flowing for your organization.
Advantages
• Consistent claim tracking and reporting
• Extensive systems experience
• Consultants are platform certified
• Experience with all Medicare, Medicaid, and commercial payers nationally
Related
Coding Services
Cash Acceleration
Interim Management
From staff training to full outsource, we’ve got your billing needs covered. Our account resolution specialists employ expert techniques so that you collect on difficult claims and keep cash flowing for your organization.
Advantages
• Consistent claim tracking and reporting
• Extensive systems experience
• Consultants are platform certified
• Experience with all Medicare, Medicaid, and commercial payers nationally
Related
Coding Services Cash Acceleration Interim Management
Cash Acceleration
If you’re experiencing payment issues, we help keep the cash flowing. Our experts help eliminate backlogs and bring receivables up to date. We know the intricacies of each payer and go a step further by identifying missed revenue, correcting claims errors, and resolving problem accounts with no disruption to your organization's daily operations.
Advantages
• Experience with all Medicare Administrative Contractors nationwide and commercial payers
• Manage accounts receivable on site or remotely
• Utilize your existing accounts receivable system or employ our secure proprietary collection system
Related
Billing Services
System Conversion Support
Interim Management
If you’re experiencing payment issues, we help keep the cash flowing. Our experts help eliminate backlogs and bring receivables up to date. We know the intricacies of each payer and go a step further by identifying missed revenue, correcting claims errors, and resolving problem accounts with no disruption to your organization's daily operations.
Advantages
• Experience with all Medicare Administrative Contractors nationwide and commercial payers
• Manage accounts receivable on site or remotely
• Utilize your existing accounts receivable system or employ our secure proprietary collection system
Related
Billing Services System Conversion Support Interim Management
Clinical Compliance Review
On matters of clinical compliance, we make sure you know where you stand and give you the tools to improve when necessary. To maintain regulatory compliance and consistently receive correct payment, our clinical team provides quality chart audits and education on thorough clinical documentation, ADR responses, and the appeals process.
Advantages
• Mock surveys to prepare for accreditation
• Quantitative audits to provide feedback on Medicare regulatory practices to show compliance
• Audit reviews to support your QAPI data
• Education sessions that improve documentation to support medical necessity and process improvement initiatives
Related
Coding Services
ADR and Pre-bill Services
On matters of clinical compliance, we make sure you know where you stand and give you the tools to improve when necessary. To maintain regulatory compliance and consistently receive correct payment, our clinical team provides quality chart audits and education on thorough clinical documentation, ADR responses, and the appeals process.
Advantages
• Mock surveys to prepare for accreditation
• Quantitative audits to provide feedback on Medicare regulatory practices to show compliance
• Audit reviews to support your QAPI data
• Education sessions that improve documentation to support medical necessity and process improvement initiatives
Related
Coding Services ADR and Pre-bill Services
Hospice Coding Services
To ensure your agency receives the correct reimbursement, and is fully compliant, our coding services are conducted by certified clinicians with meticulous attention to documentation detail and rigid quality standards.
Advantages
• All coding conducted onshore
• Every coder is certified in hospice coding (HCS-H)
• Minimum 97% accuracy rate
• Comments cited with CMS regulations and Decision Health guidance
Related
Billing Services
Webinars: Hospice Physician Documentation and Intake Needs in ICD-10 - Recording
Hospice Clinician Documentation in ICD-10 - Recording
To ensure your agency receives the correct reimbursement, and is fully compliant, our coding services are conducted by certified clinicians with meticulous attention to documentation detail and rigid quality standards.
Advantages
• All coding conducted onshore
• Every coder is certified in hospice coding (HCS-H)
• Minimum 97% accuracy rate
• Comments cited with CMS regulations and Decision Health guidance
Related
Billing Services Webinars: Hospice Physician Documentation and Intake Needs in ICD-10 - Recording Hospice Clinician Documentation in ICD-10 - Recording
Interim Management
From chief financial officer to director of nursing positions, we serve in key leadership roles within finance and clinical operations across the care continuum. Our interim managers have the leadership experience to tailor their approach to your organization’s specific needs as well as the strategic vision to achieve clinical, financial, and operational goals.
Advantages
• Real-world leadership experience in acute and post-acute care settings
• Assistance in the recruiting process, guidance during the transition, and ongoing support as needed
• Available temporary staffing
• Experienced resources, including the expertise of the entire firm to achieve engagement goals
System Conversion Support
Transition seamlessly to a new system with support from home health and hospice experts who fully understand your need for consistent cash flow and productivity during a conversion. From project management to change management, we assist you through each step of new system implementation.
Advantages
• Resolve legacy system accounts receivable as new system is implemented
• Securely maintain data from legacy system on our HIPAA-compliant storage
• System and workflow optimization to maximize potential of new system
• Customized user training on the new system
• Interim staffing support options
Related
Revenue Cycle Process Improvement
Cash Acceleration
Transition seamlessly to a new system with support from home health and hospice experts who fully understand your need for consistent cash flow and productivity during a conversion. From project management to change management, we assist you through each step of new system implementation.
Advantages
• Resolve legacy system accounts receivable as new system is implemented
• Securely maintain data from legacy system on our HIPAA-compliant storage
• System and workflow optimization to maximize potential of new system
• Customized user training on the new system
• Interim staffing support options
Related
Revenue Cycle Process Improvement Cash Acceleration
Billing & Cash Acceleration
If you’re experiencing payment issues, we help keep the cash flowing. Our experts help eliminate backlogs and bring receivables up to date. We know the intricacies of each payer and go a step further by identifying missed revenue, correcting claims errors, and resolving problem accounts with no disruption to your organization's daily operations.
Advantages
• Experience with commercial and Medicare payers
• Manage accounts receivable on site or remotely
• Utilize your existing accounts receivable system or employ our secure proprietary collection system
Related
Interim Management
If you’re experiencing payment issues, we help keep the cash flowing. Our experts help eliminate backlogs and bring receivables up to date. We know the intricacies of each payer and go a step further by identifying missed revenue, correcting claims errors, and resolving problem accounts with no disruption to your organization's daily operations.
Advantages
• Experience with commercial and Medicare payers
• Manage accounts receivable on site or remotely
• Utilize your existing accounts receivable system or employ our secure proprietary collection system
Related
Interim Management
Interim Management
From chief financial officer to director of nursing positions, we serve in key leadership roles within finance, operations, and clinical operations across the care continuum. Our interim managers have the leadership experience to tailor their approach to your organization’s specific needs as well as the strategic vision to achieve clinical, financial, and operational goals.
Advantages
• Real-world leadership experience across the healthcare continuum
• Assistance in the recruiting process, guidance during the transition, and ongoing support as needed
• Available temporary staffing
• Experienced resources, including the expertise of the entire firm to achieve engagement goals
Market Development Strategies
To maximize partnerships with referral sources and make performance improvement decisions, our consultants provide a full assessment of market factors, quality measures, resident satisfaction, and regulatory compliance to secure prime positioning in the continuum of care. Our evidence-based solutions range from strategic planning to compliance strategies aimed at increasing referral conversion, improving the patient experience, and building sustainable network relationships.
Advantages
• Real-world leadership experience across the healthcare continuum
Related
Transition of Care Management
Interim Management
To maximize partnerships with referral sources and make performance improvement decisions, our consultants provide a full assessment of market factors, quality measures, resident satisfaction, and regulatory compliance to secure prime positioning in the continuum of care. Our evidence-based solutions range from strategic planning to compliance strategies aimed at increasing referral conversion, improving the patient experience, and building sustainable network relationships.
Advantages
• Real-world leadership experience across the healthcare continuum
Related
Transition of Care Management Interim Management
Revenue Cycle Improvement
For optimization of your current workflows or a financial turnaround, our consultants collaborate to design lasting solutions at any stage in the revenue cycle. We deliver a full range of services that address every area from patient intake to cash posting. The result is always a strategic process improvement that works in your organization.
Advantages
• Total revenue cycle assessment, operations re-engineering, and process improvement
• Management and expertise from financial leaders, policy analysts, and information technology specialists
• System implementation support
• Billing loan staff and training as needed
• Accounts receivable resolution and cash acceleration
Related
Interim Management
Billing & Cash Acceleration
White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care
For optimization of your current workflows or a financial turnaround, our consultants collaborate to design lasting solutions at any stage in the revenue cycle. We deliver a full range of services that address every area from patient intake to cash posting. The result is always a strategic process improvement that works in your organization.
Advantages
• Total revenue cycle assessment, operations re-engineering, and process improvement
• Management and expertise from financial leaders, policy analysts, and information technology specialists
• System implementation support
• Billing loan staff and training as needed
• Accounts receivable resolution and cash acceleration
Related
Interim Management Billing & Cash Acceleration White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care
Transition of Care Management
Our proven strategic processes will help your organization manage the transition of care requirements. After performing an assessment, we help you create a sustainable management model that not only meets payer criteria and reduces unnecessary costs but improves patient outcomes. With our clinical recommendations and approach to education, you’ll experience sustainable results throughout your organization and be the go-to for provider referrals.
Advantages
• Skilled clinicians with extensive continuum of care experience
• Over 30 years’ experience working with skilled nursing facilities
• Real-world experience in reducing the length-of-stay and developing a care transition model in skilled nursing facilities
Related
Market Development Strategies
Interim Management
Our proven strategic processes will help your organization manage the transition of care requirements. After performing an assessment, we help you create a sustainable management model that not only meets payer criteria and reduces unnecessary costs but improves patient outcomes. With our clinical recommendations and approach to education, you’ll experience sustainable results throughout your organization and be the go-to for provider referrals.
Advantages
• Skilled clinicians with extensive continuum of care experience
• Over 30 years’ experience working with skilled nursing facilities
• Real-world experience in reducing the length-of-stay and developing a care transition model in skilled nursing facilities
Related
Market Development Strategies Interim Management
ADR & Pre-Bill Services
Prevent reduced payments with a proactive strategy. Our clinicians respond to ADRs, craft winning appeals for denied claims, and review medical records to identify essential documentation needed to prevent future denials. The firm also offers pre-bill reviews with clinical feedback and recommendations for increased compliance and improved processes.
Advantages
• Clinical consulting group with more than 20 years of experience
• Well-crafted, winning appeals
• Proprietary software tool designed for pre-bill audits
• Pre-bill audits to improve billing quality in response to Medicare focused review
Related
Coding Services
OASIS Accuracy
Billing Services
Prevent reduced payments with a proactive strategy. Our clinicians respond to ADRs, craft winning appeals for denied claims, and review medical records to identify essential documentation needed to prevent future denials. The firm also offers pre-bill reviews with clinical feedback and recommendations for increased compliance and improved processes.
Advantages
• Clinical consulting group with more than 20 years of experience
• Well-crafted, winning appeals
• Proprietary software tool designed for pre-bill audits
• Pre-bill audits to improve billing quality in response to Medicare focused review
Related
Coding Services OASIS Accuracy Billing Services
Billing Services
From staff training to full outsource, we’ve got your billing needs covered. Our account resolution specialists employ expert techniques so that you collect on difficult claims and keep cash flowing for your organization.
Advantages
• Consistent claim tracking and reporting
• Extensive systems experience
• Consultants are platform certified
• Experience with all Medicare, Medicaid, and commercial payers nationally
Related
Coding Services
Cash Acceleration
From staff training to full outsource, we’ve got your billing needs covered. Our account resolution specialists employ expert techniques so that you collect on difficult claims and keep cash flowing for your organization.
Advantages
• Consistent claim tracking and reporting
• Extensive systems experience
• Consultants are platform certified
• Experience with all Medicare, Medicaid, and commercial payers nationally
Related
Coding Services Cash Acceleration
Cash Acceleration
If you’re experiencing payment issues, we keep the cash flowing. Our experts help eliminate backlogs and bring receivables up to date. We know the intricacies of each payer and go a step further by identifying missed revenue, correcting claims errors, and resolving problem accounts with no disruption to your organization's daily operations.
Advantages
• Experience with all Medicare Administrative Contractors nationwide and commercial payers
• Manage accounts receivable on site or remotely
• Utilize your existing accounts receivable system or employ our secure proprietary collection system
Related
Billing Services
System Conversion Support
Interim Management
If you’re experiencing payment issues, we keep the cash flowing. Our experts help eliminate backlogs and bring receivables up to date. We know the intricacies of each payer and go a step further by identifying missed revenue, correcting claims errors, and resolving problem accounts with no disruption to your organization's daily operations.
Advantages
• Experience with all Medicare Administrative Contractors nationwide and commercial payers
• Manage accounts receivable on site or remotely
• Utilize your existing accounts receivable system or employ our secure proprietary collection system
Related
Billing Services System Conversion Support Interim Management
Clinical Compliance Review
On matters of clinical compliance, we make sure you know where you stand and give you the tools to improve when necessary. To maintain regulatory compliance and consistently receive correct payment, our clinical team provides quality chart audits and education on thorough clinical documentation, ADR responses, and the appeals process.
Advantages
• Mock surveys to prepare for accreditation
• Quantitative audits to provide feedback on Medicare regulatory practices to show compliance
• Audit reviews to support your QAPI data
• Education sessions that improve documentation to support medical necessity and process improvement initiatives
Related
Coding Services
ADR and Pre-bill Services
On matters of clinical compliance, we make sure you know where you stand and give you the tools to improve when necessary. To maintain regulatory compliance and consistently receive correct payment, our clinical team provides quality chart audits and education on thorough clinical documentation, ADR responses, and the appeals process.
Advantages
• Mock surveys to prepare for accreditation
• Quantitative audits to provide feedback on Medicare regulatory practices to show compliance
• Audit reviews to support your QAPI data
• Education sessions that improve documentation to support medical necessity and process improvement initiatives
Related
Coding Services ADR and Pre-bill Services
Home Health OASIS & Coding Services
To ensure your agency receives the correct reimbursement, and is fully compliant, our concurrent OASIS and coding services are conducted by certified clinicians with meticulous attention to documentation detail and rigid quality standards.
Advantages
• Minimum 97% accuracy rate, meeting highest quality standards
• Comments cited with CMS regulations and Decision Health guidance
• Every coder is certified in OASIS (HCS-O), home health (HCS-D), as applicable to their expertise, including ICD-10
• Rapid turnaround
• Web-based, HIPAA-compliant interface
• All coding conducted by U.S. based McBee employees
• Comments cited with CMS regulations and Decision Health guidance
Related
OASIS Accuracy
Billing Services
Webinars: Hospice Physician Documentation and Intake Needs in ICD-10 - Recording
Hospice Clinician Documentation in ICD-10 - Recording
Home Health Physician Documentation and Intake Needs in ICD-10 - Recording
Home Health Clinician Documentation in ICD-10 - Recording
To ensure your agency receives the correct reimbursement, and is fully compliant, our concurrent OASIS and coding services are conducted by certified clinicians with meticulous attention to documentation detail and rigid quality standards.
Advantages
• Minimum 97% accuracy rate, meeting highest quality standards
• Comments cited with CMS regulations and Decision Health guidance
• Every coder is certified in OASIS (HCS-O), home health (HCS-D), as applicable to their expertise, including ICD-10
• Rapid turnaround
• Web-based, HIPAA-compliant interface
• All coding conducted by U.S. based McBee employees
• Comments cited with CMS regulations and Decision Health guidance
Related
OASIS Accuracy Billing Services Webinars: Hospice Physician Documentation and Intake Needs in ICD-10 - Recording Hospice Clinician Documentation in ICD-10 - Recording Home Health Physician Documentation and Intake Needs in ICD-10 - Recording Home Health Clinician Documentation in ICD-10 - Recording
Episode Management
We make sure high care quality and financial viability are within your reach. Our approach to episode management improves the delivery of the patient's plan of care. Our clinical teams partner with yours to develop custom care guidelines that reduce readmissions, improve visit utilization, and provide patients with a positive outcome. Patients, and referring providers, will count on your agency for the best care and patient experience.
Advantages
• Focus on higher Quality of Patient Care and Patient Survey Star Ratings
• Clinician-to-clinician review of care plans to improve utilization
• Trend reporting to determine and address root causes of low utilization
• Analysis of open episodes to identify potential LUPAs and prevent them
• New care patterns engrained into agency culture
Related
OASIS Accuracy
Revenue Cycle Process Improvement
We make sure high care quality and financial viability are within your reach. Our approach to episode management improves the delivery of the patient's plan of care. Our clinical teams partner with yours to develop custom care guidelines that reduce readmissions, improve visit utilization, and provide patients with a positive outcome. Patients, and referring providers, will count on your agency for the best care and patient experience.
Advantages
• Focus on higher Quality of Patient Care and Patient Survey Star Ratings
• Clinician-to-clinician review of care plans to improve utilization
• Trend reporting to determine and address root causes of low utilization
• Analysis of open episodes to identify potential LUPAs and prevent them
• New care patterns engrained into agency culture
Related
OASIS Accuracy Revenue Cycle Process Improvement
PDGM Impact Analysis
Our comprehensive Impact Analysis helps you forecast the financial effects that your agency can expect under the proposed regulations by repricing your claims using the Patient-Driven Groupings Model (PDGM) for reimbursement. Armed with this information, you’ll be able to anticipate the impact in order to forecast, plan, and budget for 2020.
Advantages
• Analysis of agency’s HHRG, diagnosis coding, and claims data pulled from CMS
• Detailed reporting to thoroughly explain the impact of PDGM and how it will affect your agency
• Customized competitor analysis to identify gaps and future opportunities
• Recommendations for operational adjustments that improve financial performance
Interim Management
From chief financial officer to director of nursing positions, we serve in key leadership roles within finance and clinical operations across the care continuum. Our interim managers have the leadership experience to tailor their approach to your organization’s specific needs as well as the strategic vision to achieve clinical, financial, and operational goals.
Advantages
• Real-world leadership experience in acute and post-acute care settings
• Assistance in the recruiting process, guidance during the transition, and ongoing support as needed
• Available temporary staffing
• Experienced resources, including the expertise of the entire firm to achieve engagement goals
OASIS Accuracy
For the most thorough review on each chart, we evaluate OASIS responses and coding decisions using all available documentation.
You achieve the best clinical and financial outcomes possible by optimizing your OASIS process with a focus on compliance and nuances of proper OASIS completion.
Advantages
• Side-by-side comparison of pre-submission OASIS charts with coding and rescoring recommendations
• All reviewers certified in OASIS (HCS-O) and home health (HCS-D) with an average of more than 15 years of experience
• Recommendations cited with CMS regulations and Decision Health guidance
• Financial impact analysis of potential reimbursement on each chart
• Trend reports showing target areas for improvement
• Targeted training based on reviews by clinician and code
Contact us for a free 45 minute demonstration.
Related
Coding Services
Episode Management
Webinars: Home Health Physician Documentation and Intake Needs in ICD-10 - Recording
Home Health Clinician Documentation in ICD-10 - Recording
For the most thorough review on each chart, we evaluate OASIS responses and coding decisions using all available documentation.
You achieve the best clinical and financial outcomes possible by optimizing your OASIS process with a focus on compliance and nuances of proper OASIS completion.
Advantages
• Side-by-side comparison of pre-submission OASIS charts with coding and rescoring recommendations
• All reviewers certified in OASIS (HCS-O) and home health (HCS-D) with an average of more than 15 years of experience
• Recommendations cited with CMS regulations and Decision Health guidance
• Financial impact analysis of potential reimbursement on each chart
• Trend reports showing target areas for improvement
• Targeted training based on reviews by clinician and code
Contact us for a free 45 minute demonstration.
Related
Coding Services Episode Management Webinars: Home Health Physician Documentation and Intake Needs in ICD-10 - Recording Home Health Clinician Documentation in ICD-10 - Recording
Revenue Cycle Improvement
For optimization of your current workflows or a financial turnaround, our consultants collaborate to design lasting solutions at any stage in the revenue cycle. We deliver a full range of services that address every area from patient intake to cash posting. The result is always a strategic process improvement that works in your organization.
Advantages
• Total revenue cycle assessment, operations re-engineering, and process improvement
• Management and expertise from financial leaders, policy analysts, and information technology specialists
• System implementation support
• Billing loan staff and training as needed
• Accounts receivable resolution and cash acceleration
Related
Interim Management
Cash Acceleration
Episode Management
White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care
For optimization of your current workflows or a financial turnaround, our consultants collaborate to design lasting solutions at any stage in the revenue cycle. We deliver a full range of services that address every area from patient intake to cash posting. The result is always a strategic process improvement that works in your organization.
Advantages
• Total revenue cycle assessment, operations re-engineering, and process improvement
• Management and expertise from financial leaders, policy analysts, and information technology specialists
• System implementation support
• Billing loan staff and training as needed
• Accounts receivable resolution and cash acceleration
Related
Interim Management Cash Acceleration Episode Management White Paper: Turning Around a Health Care System in a Global Cap Environment: A Balancing Act in Acute and Post-Acute Care
Revenue Recovery
To prevent financial risks associated with underpayments and overpayments, we help you receive accurate reimbursement for paid Medicare claims and engrain compliant practices to protect your bottom line. Our revenue recovery process is built to handle every step from claim review to payment verification.
Advantages
• Industry leader in Medicare revenue recovery since the inception of PPS
• National reputation for offering the most comprehensive screening and review methodologies
• Guidance in revamping billing and operational processes
• Contingency-based fee structure
Related
OASIS Accuracy
Coding Services
To prevent financial risks associated with underpayments and overpayments, we help you receive accurate reimbursement for paid Medicare claims and engrain compliant practices to protect your bottom line. Our revenue recovery process is built to handle every step from claim review to payment verification.
Advantages
• Industry leader in Medicare revenue recovery since the inception of PPS
• National reputation for offering the most comprehensive screening and review methodologies
• Guidance in revamping billing and operational processes
• Contingency-based fee structure
Related
OASIS Accuracy Coding Services
System Conversion Support
Transition seamlessly to a new system with support from home health and hospice experts who fully understand your need for consistent cash flow and productivity during a conversion. From project management to change management, we assist you through each step of new system implementation.
Advantages
• Resolve legacy system accounts receivable as new system is implemented
• Securely maintain data from legacy system on our HIPAA-compliant storage
• System and workflow optimization to maximize potential of new system
• Customized user training on the new system
• Interim staffing support options
Related
Cash Acceleration
Revenue Cycle Process Improvement
Transition seamlessly to a new system with support from home health and hospice experts who fully understand your need for consistent cash flow and productivity during a conversion. From project management to change management, we assist you through each step of new system implementation.
Advantages
• Resolve legacy system accounts receivable as new system is implemented
• Securely maintain data from legacy system on our HIPAA-compliant storage
• System and workflow optimization to maximize potential of new system
• Customized user training on the new system
• Interim staffing support options
Related
Cash Acceleration Revenue Cycle Process Improvement
EXPERTISE GUARANTEED
All consultants, from junior staff to senior management, know health care policy at a granular level, and stay ahead of all compliance issues that could impact clients.
To ensure subject matter expertise on the application of policies, and the development of practical approaches to new regulations, bi-weekly training sessions are conducted, during which The Federal Register is reviewed. We guarantee that engagements are staffed with consultants with in-depth knowledge of health care policy and compliance, including:
- Medicare
- Medicaid
- JCAHO
- HIPAA
Compliance with health care policy and regulations is an integral part of all phases of client engagements and the firm’s internal training processes. McBee helps clients establish, update, and review compliance programs. The firm’s compliance expertise is also utilized internally by maintaining an active compliance program that includes training, risk assessment, extensive review of high-risk engagements, and self-audits. McBee believes that compliance is essential to good business.
- Extensive health care regulation research
- Documentation of opinion
- Continuous regulatory training
- Comprehensive policy implementation
