WHICH SEMINAR DO YOU ATTEND?

All of us have gone to conferences and seminars and webinars, and watched webinar series – we’ve done that for years. Everyone has to budget for them every year. But not everything you go to is all that useful. Or even when it is, you may have questions that you didn’t get to ask before, and now you can’t talk to the speakers anymore. So you have to balance the cost of going to those events versus the benefits you actually get from them.

WE DECIDED THERE SHOULD BE

We want to help improve patient care, reduce denials and appeals, reduce preventable deaths and reduce physician burnout. One the ways we do that is to offer hospitals like yours a way to design your own seminar of expert presentations that can  be delivered at your site. We now make it possible for you to do what you thought was impossible... Build your own revenue cycle seminar...  

THE FIRST STEPS...

Let's focus on how we start this process, with an introductory meeting, the purpose of which is setting up a conference call with whomever you choose at your hospital to contribute to lining up an agenda for your seminar.

CLINICAL DOCUMENTATION...

(Bet you guessed this one, right?)

Every goal we have is dependent upon improving clinical documentation including the behaviors and processes that produce it. Keep in mind that for many years running now, about 85% of payer denials are a result of inadequate or poor or missing documentation. Given that FACT, working to improve documentation offers to return the biggest bang-for-the-buck, so to speak. Nuff said.

MEDICAL CODING

Of course we also suggest medical coding as a topic, for many reasons, not the least of which is how dependent it is on documentation, and the fact that the topic remains one of the top concerns of management, industry wide.  Even great documentation won't save you without proper coding to ensuring accurate reimbursements and a valid record of patient care history.

CHARGE CAPTURE

Charge capture is really a form of documentation, if you think about it like we do… and there are many methods being used to accomplish it… unfortunately, payor rules, terminology and codes change frequently, so there needs to be some kind of process to make sure you capture what happens clinically and how that affects the accuracy and completeness of billing.

APPEALS & DENIALS

Appeals – and of course this must include Denials management, but as I already mentioned, the goal is to continuously improve your processes and results. Winning appeals is a great accomplishment, but you don’t even need to write an appeal if you avoid the denial that was its genesis. We’d like to make sure that the right metrics are being used to show true improvements.

REGISTRATION

Registration is waaaay up front in your revenue cycle, you might call it patient access. This is becoming even more important as time goes on, and we want to make sure everyone recognizes the crucial nature of what needs to happen here, even this early in the whole process.

SCHEDULING

Scheduling – no matter how you do this now, there’s a lot of focus on this of late, and we think it needs even more focus than we see in general. And of particular interest is the ability to properly determine appropriate status for surgery claims, submitted to either commercial or government payer programs.

CASE MANAGEMENT

Case management has been going through some changes over the past few years, all aimed at improving the ability of case managers to help identify appropriate providers and facilities throughout the continuum of services, all the while ensuring that available resources are being used in a timely and cost-effective manner, with a goal to obtain optimum value for both the patient, the hospital and the payer. Your staff need continuing education to render appropriate services based on sound principles of practice.

UTILIZATION REVIEW

Utilization Review… now has an ever-increasing emphasis on reducing costs while still improving patient outcomes. So if reducing costs and improving outcomes for patient care are good goals, then being able to confirm that plans of care are covered and appropriate in the payers’ eyes is critical to all our stated goals.