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Because your patients come first. Regulatory and Practice Management Services Daniel L. Johnson, CPC, CPC-H.

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Presentation on theme: "Because your patients come first. Regulatory and Practice Management Services Daniel L. Johnson, CPC, CPC-H."— Presentation transcript:

1 Because your patients come first. Regulatory and Practice Management Services Daniel L. Johnson, CPC, CPC-H

2 Because your patients come first. Because Your Patients Come First Practice Management Services Total Practice Management Practice Evaluations Revenue Cycle and Fee Schedule Analysis Strategic Planning Business Plans Practice Valuations Managed Care Contracting Presentations

3 Because your patients come first. Because Your Patients Come First Practice Management Services Total Practice Management Description: For the approximate cost of a full-time employee, MMHSI can oversee and manage the day-to-day operations of a medical practice.

4 Because your patients come first. Because Your Patients Come First Practice Management Services Total Practice Management Consulting and management support of a medical practice to include but not limited to the processing of insurance claims, accounts receivable, accounts payable, and other reporting as may be required by the physicians. Monthly on-site visits by a member of the Consulting Staff of MMHSI for oversight. Monthly reporting on the operations of the office will be provided. Consulting support for CPT/ICD- 9/Medicare/Medicaid and other Third Party Payers as related to physician billing.

5 Because your patients come first. Because Your Patients Come First Practice Management Services Practice Evaluations Description: Assesses practice operations and management. An on-site assessment of 2-3 days is necessary and written report of findings and recommendations are provided.

6 Because your patients come first. Because Your Patients Come First Practice Management Services Practice Evaluations Assess billing operations, collections, and accounts receivable; Coding and documentation review; Comparative Profile Analysis EO(M)B Review (review of denied services) Patient Mix Analysis Patient Flow Staffing Analysis Regulatory Compliance Review

7 Because your patients come first. Because Your Patients Come First Practice Management Services Revenue Cycle and Fee Schedule Analysis Practice Management Services Revenue Cycle and Fee Schedule Analysis Description: Review billing, collections, and accounts receivable process and makes specific recommendations for improvement. Current Fee Schedule is reviewed and compared to our extensive database of physician fees. Recommendations are made to change charges to current market levels.

8 Because your patients come first. Because Your Patients Come First Practice Management Services Strategic Planning New Business Structures Develop New or Updated Management Teams Enhance your Business Develop New Revenue Streams

9 Because your patients come first. Because Your Patients Come First Practice Management Services Business Plans New Business Ventures Obtaining Capital Investment New Practice Startups

10 Because your patients come first. Because Your Patients Come First Practice Management Services Practice Valuations Valuations of Hard Assets Valuations of Intangible Assets (Good Will) Evaluation of Regulatory Compliance for Valuation Purposes Evaluation of Cash Flow and Collections Evaluation of Staffing and Expenses Assign Dollar Value to Your Practice

11 Because your patients come first. Because Your Patients Come First Practice Management Services Managed Care Contracting Evaluation of Current Contracts Evaluation and Negotiations of Fee Schedules Evaluation and Recommendations for Future Contracts Direct Contracting Capitation Evaluation

12 Because your patients come first. Because Your Patients Come First Practice Management Services Presentations Practice Evaluations Revenue Cycle Analysis Organization Management Managing and Motivating Staff

13 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services Medicare/Medicaid/Third-Party Payer Audit Defense Voluntary Compliance Programs Individual and Corporate Integrity Agreements Voluntary Disclosures HIPAA Compliance Programs OSHA Reviews/Training/Compliance Research and Coverage Analysis New CPT Development Legal Assistance and Support Services

14 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services Audit Defense Consulting Services Related to Disputing Overpayment Demands Statistical Analysis Fair Hearing and Mediation Representation Administrative Law Judge Hearing Assistance Attorney Support Services Research Audits Other Analysis as Needed

15 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services Voluntary Compliance Plans Establish Voluntary Program Designed to Limit Audit/Fraud& Abuse/Whistle-Blower Cases Custom Program Designed for Your Practice/Business Meets OIG Compliance Guidance Annual Auditing and Monitoring

16 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services Individual and Corporate Integrity Agreements Recognized as Independent Review Organization by the OIG Statistically Valid Design and Auditing Annual Reporting and Monitoring Customized Compliance Program to Meet Integrity Agreement Goals

17 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services Voluntary Disclosures Mediation with Payers Confirmatory Audits Corrective Action Plans Auditing and Monitoring to Assure Compliance

18 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services HIPAA Compliance Programs Compliance Manual Training Implementation Form Development Dispute Resolution

19 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services OSHA Reviews/Training/Compliance Initial Safety Evaluation and Report Safety Manuals Blood Borne Pathogen Manuals Training Complaint Investigation and Resolution Management

20 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services Research and Coverage Analysis Complex Coding and Reimbursement Issue Analysis National and Local Coverage Decision Research and Analysis New or Revised Coverage Determination Development

21 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services New CPT Development Direct Liaison with AMA CPT Advisory and Editorial Panel Single Specialty Society Involvement Research and Plan Development Presentation and Follow-up Services

22 Because your patients come first. Because Your Patients Come First Regulatory Compliance Services Legal Assistance and Support Services Fraud and Abuse Defense working with Legal Counsel Administrative Law Judge Hearing Assistance Expert Testimony Auditing Research and Analysis


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