Revenue Cycle Management

Our billing philosophy starts with maximizing reimbursement while ensuring no encounters are left behind. It continues with cutting expenses by introducing high-end technology. We understand that when our competitors offshore any piece of the process, it breaks the focus on reimbursement, compliance and communication for a low end option to reduce costs.

You will meet with our department leaders to orient us on all aspects of your practice. Our team will then create a process that is customized to fit your needs while optimizing results. Together, we forge a strategy for the future to improve your process to ensure you will beat out your peers from a financial, regulatory and organizational perspective.

Our Service Options Include:

  • Bridging your EMR to our system
  • Charge Capture Technology
  • MIPS Strategy and Management
  • Our own EMR options
    • Reduce your EMR costs with our discounted rate
    • Attest for MIPS
  • Denial Appeals
  • Medical Coding
  • RCM Liaison
    • Your direct connection for all billing matters
  • Verification Services
  • Rejection Processing
  • Patient Eligibility Checks
  • Pre-authorizations
  • Payment Processing
  • Customized Report Package
  • Provider Credentialing
  • Documentation Training
  • Electronic Claim Submission
  • Electronic Remittance Advice
  • Salus Resource Group
    • Medical Executive Network to handle needs outside of our services

We can accommodate any of our services individually to suit your needs. Our rates are based on reimbursement and scale depending on specialty, volume and which services are elected for implementation.

Credentialing

Aggressive credentialing is essential to open the financial floodgates to your practice. This service allows you to focus on your passion while our experts manage your enrollment and insurance contracts.

It is crucial to partner with an experienced staff that will not sit idle and allow time to pass by, costing you thousands of dollars in unpaid yet deserved revenue. Our knowledge and personal rapport with the local insurance companies give us the upper hand and experience our competitors simply cannot match.

Service Options Include:

  • Payor Enrollment
  • CAQH Maintenance
  • Re-credentialing

It is our responsibility to stay up to date on all of the everchanging forms and processes each insurance company demands, which in turns cuts credentialing time by 30 – 70 percent when compared to our competitors.

Credentialing is a challenging process that is successfully completed in a timely manner by our competent and organized staff who understands the importance of accuracy.

Our mission is to decrease time lapses in contracting in order to increase the rate of which revenue is generated, and we do not stop there. We provide you with 24 hour access to your team’s status. Additionally, we forecast booking of new patients under your payors to efficiently complete the process.  We may work directly with your clinicians and always provide transparency and updates to your administration.

If a payor denies your request to join their panel, we will fight (at no extra charge) on your behalf to convince the payor why your practice ought to be embraced and added on.

We take pride in our ability to go the extra mile for our clients. It makes a very strong and positive impact to have a passionate staff working on your behalf. We understand the organization, productivity and dedication that credentialing requires and our clients deserve nothing less than the very best.

Payor enrollment service options range from $250.00 to $2,000.00 per individual provider or business entity.

Business Strategy

We will train your staff or providers or advise your decision makers on a consultative basis to become self-sufficient or complete a major project. Our medical management secrets will allow you to maintain your current business model yet benefit from masters in the field who are trained every year on the optimal methods for maximizing reimbursement.
 
Our trusted vendors are sure to handle anything that exceeds our grasp. We can help you launch a new practice, create a business plan to finance new equipment, find a new practice location… virtually any needs in the medical executive space, can be filled by our resource group.

MIPS Solutions

MIPS is the most impactful change affecting your practice this year. The potential of losing revenue through penalized fee schedules over the next 6 years should be your chief financial concern. An evaluation of your practice is imperative. There are very few MIPS experts, but the tracking process began on January 1st 2017 and nearly all clinicians are already being assessed.

 

It is crucial that the necessary strategies are implemented prior to data submission as your MIPS score will follow you for the rest of your medical career, much like a credit score. This score will be accessible to potential patients, meaning if a patient sees a Low-Quality Performance score, they are less likely to choose you as their provider.

 

We have the capability to ensure the appropriate strategy is implemented for your practice or healthcare organization, leading to a compliant and prosperous path to your success.

 

Discovery Phase

Our first meeting will evaluate your practice in terms of attaining the required benchmarks. We will travel to you or host your team at our corporate headquarters. This is a thorough information gathering session. We will learn your past experience with quality measures, educate your team on what to expect from MIPS and discuss your anticipated goals for the future. Our trained experts will work to fill in any missing pieces of information that you were not able to provide during the discovery phase.

 

Analysis Phase

We will then organize and analyze the data internally to identify your deficient areas that must be addressed to reach your anticipated goals. We will review your quality performance, advancing care information, clinical practice improvement and resource use to measure what your potential score would be without the necessary adjustments. We then evaluate your past experience, your payor mix, a financial impact forecast over 4 years, and realistic resource options.

 

Strategy Phase

In our final meeting, we will provide our implementation advice to achieve your goal. We will advise necessary improvements in appropriate areas, ensuring you positive MIPS score potentially leading to higher fee schedules and reimbursements to your practice. Our recommendations not only serve you for this submission year, but going forward you will know what to record and what other activities to participate in to achieve a high score in the upcoming years. Your positive MIPS score will speak to your patients, hospital affiliates and potential employers, showcasing the advanced quality of service you provide to your patients.

Encounter Auditing

Are you maximizing your reimbursement for the services that you are providing? Do you fear an insurance audit may result in a negative outcome, leading to a significant financial penalty? Are your in-house guidelines current?

Our experts will analyze and identify your practice’s weaknesses and short-falls with our chart review system and in return, strengthen your practice. If you have a focused concern, we will target your specific items. We believe every practice has an individual philosophy, and because of this we will help you reach your required compliance goals.

Medical Record Review – Our auditors will review your medical records and determine the accuracy of billed services. Each provider will be critiqued on all elements of their documented history, physical examination and medical decision making. Additionally, we will review your choice for ICD diagnoses and CPT service codes.

We will highlight which areas your providers are omitting to ensure they will be better insulated from an audit. Conversely, we will determine if your providers are over-documenting and indicatehow they can save precious time in their daily routines or perhaps choose a higher level of billing if appropriate. Our reports will be provided to your administrator for review and we will discuss the results to ensure proper interpretation.

Missed Charge Opportunity (MCO) Revelation – There are over 1,000 pages of available services and procedures across CPT and HCPCS. This list of procedures changes every year. Insurance companies pivot quarterly on which codes they will reimburse. We will review and reveal which codes you can submit for services being performed! This will raise your ceiling for future reimbursement.

Insurance Audit Appeals – If your practice is audited and receives a negative outcome, allow our team to determine if you have a case for an appeal. Payors often make mistakes during their audit process. The DMS coding staff will construct the appeal on your behalf. We will advocate your position with all of the necessary documentation to support the appeal and stand behind you every step of the way.

Documentation Training

There is no better way to improve your clinician’s documentation than to have our experts sit face to face with your providers and discuss the results of our review. In this candid discussion, we will furnish proof of our findings and the regulations that govern our findings. Since we have performed this service for 15 years, we are also able to discuss practical resolutions for changing your provider’s routines. We also offer a group meeting format to discuss troubles that sweep the entire practice. This allows valuable cross-talk between providers to share their own experiences and learn from each other.
Documentation Handbook – Our team will create a handbook tailored to the services your practice employs. It covers the requirements for documentation and reminds you of services you may not otherwise consider for billing. It also will include clinical examples that are appropriate for your specialty. We will remove the legalese and provide understandable language to allow for a practical reference. This may be provided as a PDF or as a hard copy. Most of our clients keep this handbook in a physical form, in an administrative space, physician lounge, or the location where medical notes are typed or dictated.

Charge Capture Solutions

Your team can perform billing by simply swiping on their mobile phone with this amazing technology. This is an ideal technology leap for independent groups or staff clinicians providing healthcare in a facility setting (hospital, SNF, LTAC etc).  The patient demographic and insurance information is matched to the provider’s billing in an automated fashion and transmitted in seconds through the cloud on its delivery path to our corporate office.

Discounts are available for part time providers, counselors, and advanced practitioners.

 

Click here to see a demo of our Charge Capture solution http://www.screencast.com/t/OyCnJSJLAp

EMR

DMS has partnered with EMR companies to provide a discounted rate to clients and maintain options for Stage 3 Meaningful Use, Quality Performance, ACI, Clinical Improvement Activities and Resource Use attestation. This means you will have all the tools to report for MIPS on your tablet or laptop.

As we learn about your practice and budget plan, we will suggest and provide a demonstration of our best solutions. All of our EMR solutions connect directly to our headquarters to allow the instant transmission of your encounters for billing submission.

To make your practice even more productive, our software offers:
· Status of patients moving from the waiting room to the exam room and which rooms are available

· Metrics on how long your patients wait to be seen by the provider

· Overview of patient medical summary

· E-prescribe and E-lab with options to refill or deactivate medications

· Patient Portal

· Financial and clinical data

EMR Bridging

Keep your EMR and create a direct sync with our software to minimize the turnaround time from a patient visit to insurance reimbursement. We invested in our internal system to create a digital bridge that connects nearly every EMR on the market to our headquarters! No more worrying about faxing, scanning or mailing all your superbills to your billing company. If you do not wish to engage in a digital bridge, we will create a user access point to allow our team “view only” access to your EMR to procure all necessary information to complete the revenue cycle process.