Services & Resources

Health System and Physician Integration
  • Practice Analysis and Improvement
  • Physician Health System Affiliation and Employment Strategies
  • Physician Compensation Model Design
  • Fair-Market Value Assessment for Compensation and Financial Interests
  • Strategic Planning and Implementation
  • Management of Physician Divisions and Related Entities for Health Systems 
  • Governance and Leadership Counseling and Training for Board Members
Regulatory Compliance Design and Training
  • Development of Compliance Programs
  • Personnel Training and Orientation to Maintain Program Integrity
  • Management and Administration of Compliance Programs for Provider Organizations, including Pharmacy Manufacturers, Distributors, Benefit Administrators, and Retail Providers
  • Design of Policies and Plans to Monitor and Control Compliance with Stark, AKS, IRS, HIPAA, EHR and ACA Requirements
 Medicaid and Medicare Financial Consulting
  • Development of Special Medicaid and Medicare Programs for State and Local Government Providers
  • Upper Payment Limit and Intergovernmental Transfer Program Design 
  • Public Ambulance Program Consulting
  • Long Term Care Program Consulting
Affordable Care Act
  • Formation and Management of Provider Contracting Organizations, including ACOs and ACO look-alikes
  • Pre-Contract Due Diligence Assistance
  • Assessing Systems Compatibility Between Contracting Healthcare Providers
  • Structuring Healthcare Mergers and Joint Venture Arrangements
  • Behavioral Health Provider Readiness Assessment
Behavioral Health Regulatory Compliance
  • Management Systems Assessment
  • Fiscal Reporting Controls
  • Clinical Manager/Staff Dashboard Design
  • Review and/or Develop Systems to Assure Access, Quality Outcome, Health Integration, and Cost Containment
  • Revenue Enhancement Strategies
  • Strategic Planning
  • Program Data Benchmarking
  • Internal Client Record Review Systems
  • Educational Presentations regarding New Requirements of Changing Healthcare Market
Chart Reviews
  • Under- or over-coding based on documentation of three key components
  • Medical necessity documented in the chief complaint 
  • ICD-10-CM coding to the greatest level of specificity    
  • Coding based on time, when appropriately documented   
  • Use of correct modifiers 
  • Correct units for all drugs, vaccines and administration codes
  • Documentation by exception, copy/paste functionality, clones records   
  • Written orders for all diagnostic testing
  • Use of ABNs when appropriate
  • Incident-to billing requirements met
  • Timeliness of signatures
  • Use of scribes
  • Required documentation for operative reports and correct surgical coding 
  • NCCI bundling edits
  • Review of EOBs, adjustments, payment posting, and appropriate billing to patients
Financial/Operation Assessment
  • Financial Benchmarking
  • Payer Credentialing
  • Review Practice Compliance Plan
  • Front Office / Scheduling / Intake
  • Billing Office functions
  • Fee Schedule Analysis, upon request
  • EHR / Documentation and Coding Processes
  • Policies and Procedures 
  • Employee billing and coding education
  • HIPAA training and compliance guidelines
  • Financial, internet and IT security issues
  • Other items as requested of deemed appropriate