From Payer Contracts to Bad Debt
HCMA can analyze the revenue cycle from start to finish and determine where improvements are needed. Along the way we will measure critical processes and develop recommendations. This is your business engine for generating revenue and must perform at a high level!
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Benchmarking
You improve what you measure. Development of critical benchmarks combined with reporting of actual results empowers management to implement change for improvement.
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Process Improvement
Have you done it this way forever? And will it be that way for the hereafter? Maybe not. HCMA can provide a thorough analysis that will enhance efficiency, maximize revenue and improve the use of resources to do the job.
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Management Reporting
HCMA will evaluate reports and recommend changes for maximum benefit and consistency. Periodic reporting on operational performance needs an organizational “fit” customized to enhance decision making. Too often, some reports are not used while others do not measure the correct activity.
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Reimbursement Modeling
HCMA can perform “what if” scenarios to evaluate opportunities for revenue improvement. Reimbursement modeling can be used in a variety of ways to the advantage of the practice.
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Payer Mix Analysis
HCMA can analyze your exposure to insurance contracts and government payers and determine the performance of the practice against maximum reimbursement levels. Opportunities to modify the payer mix will be evaluated to increase revenue.
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Fee Schedule Evaluation
HCMA can analyze your fee structure to identify weaknesses and determine areas for change. This process requires an in-depth analysis and may lead to enhanced revenue opportunities.
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Gross and Net Collection Rates
Each of these measures has strengths and weaknesses and should be used to fit the circumstances desired. HCMA will develop a consistent plan for the practice and incorporate collection rates into other aspects of the practice for maximum advantage.
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Strategy and Practice Profile
HCMA can develop your practice profile and recommend a strategy for achieving goals in the managed care environment. Practice leadership’s plans for a three to five year horizon are an integral part of the strategy. Assessment of the market, your competition, and an understanding of goals and risk all play a part in strategy development.
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Financial Analysis
HCMA has comprehensive analysis tools that enable the practice to evaluate current reimbursement and proposed rates for negotiation purposes. These tools are flexible and can be utilized at the group or individual provider level. Don’t sign any contract without this evaluation!
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Contract Review and Negotiations
HCMA has extensive experience with all types of contracts and reimbursement mechanisms. We will be your advocate in negotiations with payers to achieve the best outcomes. Simply signing a contract without professional expertise that incorporates all aspects of the practice is a big mistake!
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Post-Contract Analysis
Contract management is an essential but often neglected part of the managed care landscape. How do you know if the practice is being paid the contracted amounts? HCMA will analyze contract performance measurements and report variances that need attention. It’s not all just about rates. HCMA’s reporting and analysis package will spot problem areas and recommend action plans to practice leadership. Maximize your contracts!
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Analysis of Current Coding Practices
HCMA can evaluate current coding practices for accuracy and compliance adequacy. Audits of coding patterns and reporting results often reveal opportunities for revenue enhancement and compliance improvement. Modifiers and place-of-service coding are incorporated into the evaluation. Encounter form and other coding mechanisms will be evaluated.
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Training of Staff and Physicians
HCMA offers on-site training programs on CPT and ICD-9 coding for staff and physicians that enables the practice to achieve a high level of accuracy on a permanent basis. It is essential that this front-end function be of the highest quality to achieve back-end efficiency, receive proper reimbursement and avoid compliance exposures.
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Organization and Governance
HCMA can assist the practice with organizational issues and design governance customized to fit the group. Authority/ responsibility assignments are an integral part of an effective organization and can be incorporated into your structure to achieve the best performance of the group.
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Web Site Design
Do you need to create or enhance your exposure on the web? Patients appreciate the convenience of accessing information about your practice without going through the phone tree and experiencing long wait delays. This also creates staff efficiencies within the practice. HCMA can provide expert web design services customized to your practice and desired image.
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Group Purchasing
HCMA can recommend group purchasing organizations for your consideration. The practice can compare prices and service to develop a more cost efficient profile.
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