PROJECTS
PROJECT 1
EHRs
•Provide training and support services to assist doctors and other providers in adapting
•Offer information and guidance to help with EHR implementation and customization
•Give technical assistance as needed
• Provide outreach and support services.
•Help your practice EHR meet qualifications and criteria
Coding Services:
Many practices require long or short-term coding assistance. P.F.F. offers coding expertise for clients
looking for a solution to the coding dilemma so many practices face. My coders code all visits in a
timely fashion in compliance to federal guidelines and modifications, to ensure My clients can
bill these claims as soon as possible, and receive maximum revenues in.
Charge Capture Analysis
Provide feedback to the providers concerning any areas of improvement discovered in the
coding process, to ensure maximum reimbursement utilizing charge capture analysis and
management.
Accounts Receivable Recovery and Project Receivables:
Provides services to clients who are looking for a temporary or permanent solution to their accounts
receivable issues. My experienced staff can maximize collections on new billings or the older, more
difficult accounts for practices by assigning dedicated reimbursement analysts to focus on these
accounts.
Electronic Claim Submission:
Electronic claim submission is a proven method to reduce payment delays and billing errors. This
service allows customers to receive payment s in as little as seven days. For those practices who
chose to process claims with in the practice, I offer setup and submission of electronic claims to all
insurance and government payers who allow electronic submission.
PROJECT 2
Evaluation and negotiation Of Payer Contracts:
Most practices are too overwhelmed with the day-to-day issues to appropriately evaluate and
negotiate contracts with the insurance companies. Not only can contract arrangements be time
consuming to review and difficult to understand, they can often be dangerous to your financial well-
being, which can include significantly increasing your administrative costs and burden.
My goal is to help medical professionals help better understand these contracts before committing to them. I will point out the advantages and disadvantages of each contract your Medical group is considering.
Some of the services we provide are:
• Review and summarize the contract into easy to understand language.
• Provide an analysis of the financial impact of the contract.
• Provide a background check of the financial soundness of the insurance company.
• Evaluate the pros and cons of your contract obligations prior to signing and make recommendations
• Negotiate on your behalf.
Consulting and Auditing Services:
I offer training from experienced professionals who apply their expertise to your practices needs.
Through insightful questions, objectives evaluations, and in-depth analysis, Physician Fees First
provides consulting services to focus on your practice financial needs.
Here are some areas of focus:
Revenue Cycle-
I will determine the main roadblocks in the revenue cycle and create or redesign
the process to eliminate these roadblocks. Assess current work-flow including scheduling,
registration, billing, and collections. Evaluate the business office policies, procedures and collection
rate.
Payer Mix:
Determine the percentages of revenue services to total revenues or practice, facility or
physician.
Reimbursement Analysis:
Review reimbursement amounts for the appropriate level to ensure
maximum reimbursement from third party payer and comparable contracts.
Returned claim processing: We will review your current account follow up and denial process and
assist your practice in building an effective process to reduce errors, correct billing errors more
efficiently, and increase revenue.
PROJECT 3
Evaluation and Management Auditing:
I perform audits on actual patient claims and review all documentation requirements for meeting the coding levels for all patient visits.
Compliance Plan Creation and Implementation:
Over the past several years, the health care industry has endured a tremendous amount of change involving the increases in regulatory requirements and constrictive reimbursement environment. Of concern, the federal government has increased its efforts to investigate the authenticity of physician’s bills, recoup revenues from over-payments and impose legal sanctions. My compliance plan is a means to help groups reduce their fraud and abuse exposure. Whether you are a solo practitioner, a small group practice, or a large medical facility, I am ready to assist your organization with the development, and /or review of its compliance program.
My approach is to create and or provide your organization with its own unique, simplified compliance focused plan using individual customized business model that promote positive outcomes of ensured compliance and algorithms that help avoid sanctions, and issues with potential governmental problems with practice billing and reimbursement methodologies.
The Key areas of focus to meet compliance needs are:
• Assist in the development of the overall compliance plan Mission
• Objectives that maximize compliance to lessen exposure and reduce potential sanctions.
• Define lines of authority and responsibilities
Policies and procedures that address the following areas:
o Training and education of staff and physicians.
o Develop and or modify Personnel manual and communication systems and or processes.
o Establish and or modify Employment agreements.
o Establish medical Billing, medical documentation, and medical necessity outlines and algorithms.
o Communication systems for reporting problems, corrections, and follow up
o Modification of systems to prevent future offenses
o Continual monitoring, auditing and process improvement.