Practice Management

Comprehensive Compliance Audits:

Conducting thorough reviews of the practice's billing and coding practices, documentation standards, patient privacy protocols (HIPAA), and adherence to regulations from organizations like the OIG(Office of Inspector General). This involves reviewing patient charts, billing records, policies, and procedures.

Risk Assessment:

Identifying specific areas within the practice that pose a higher risk of non-compliance based on their operations, billing patterns, and regulatory focus areas. This helps prioritize areas for improvement.

Policy and Procedure Review and Development:

Evaluating existing compliance policies and procedures for adequacy and effectiveness. Developing new or revised policies to address identified gaps and ensure adherence to current regulations.

Documentation Review:

Assessing the quality and completeness of medical documentation to ensure it supports the codes billed and meets payer requirements and legal standards.

HIPAA Compliance Assessment:

Specifically reviewing policies and procedures related to patient privacy and security, including data access, breach notification, and staff training on HIPAA regulations.

Development of Corrective Action Plans:

If compliance issues are identified, consultants will help develop and implement a detailed plan to address the deficiencies and prevent future occurrences.

Ongoing Monitoring and Updates:

Providing regular updates on changes in regulations and offering guidance on how the practice needs to adapt its processes and policies.

Workflow Optimization:

Analyzing existing workflows for patient scheduling, check-in/out, rooming, documentation processes, referral management, and internal communication. Identifying bottlenecks, redundancies, and inefficiencies, and then designing streamlined, standardized processes to improve staff productivity and patient flow.

Staff Training and Development (Beyond Billing/Coding):

Developing and delivering training programs focused on customer service, patient communication skills, front office procedures, appointment scheduling best practices, telephone etiquette, and team collaboration. This aims to improve patient satisfaction and create a more positive work environment.

Technology Implementation and Integration (Broader Scope):

Assisting with the selection, implementation, and integration of various technologies beyond EHR and billing systems, such as patient portals, telehealth platforms, online scheduling tools, and communication software. Ensuring these systems work together seamlessly to enhance efficiency and patient engagement.

Patient Communication Strategies:

Developing and implementing strategies to improve patient communication, including appointment reminders, pre-visit instructions, post-visit follow-up, handling patient inquiries and complaints, and utilizing patient portals effectively. This can lead to improved patient satisfaction and reduced no-show rates.

Financial Performance Analysis (Beyond Billing):

Analyzing overall practice financial health, including expense management, budgeting, revenue diversification opportunities (e.g., cash-based services), and cost-effectiveness of different operational areas.

Marketing and Patient Acquisition Strategies:

Providing guidance on marketing efforts to attract new patients and retain existing ones, including online presence, local outreach, and referral programs.

Human Resources Consulting:

Offering advice on staff recruitment, retention strategies, performance management, and organizational structure to build a high-performing team.

Tailored Training Programs:

Recognizing that different roles have different needs,consultants develop customized training modules for various staff members, including:

• Front Office Staff: Training on patient registration, insurance verification, appointment scheduling, patient communication, co-payment collection, and handling patient inquiries.

• Billing Staff: In-depth training on claim submission processes, payer rules and regulations, electronic billing software, payment posting, and basic denial management.

• Coding Staff: Comprehensive education on ICD-10, CPT, and HCPCS coding systems, modifier usage, documentation requirements, and coding updates.

• Clinical Staff: Training on the importance of accurate and complete documentation to support coding and billing, as well as understanding the impact of documentation on reimbursement.

• Management Staff: Training on revenue cycle management principles, key performance indicators, compliance oversight, and strategies for improving team.