REVENUE CYCLE MANAGEMENT SERVICES

C+ Consulting is pleased to offer comprehensive and cost-effective services which address any concerns regarding liabilities or potential issues that may be present in the existing revenue cycle structure, specific to your outpatient Wound Management Center (WMC).  These services identify strengths, weaknesses, and opportunities for improvement as well as the need for education and tools to resolve mistakes that are costing you money.  As a result, your Center will be better positioned to comply with regulatory requirements, reduce billing errors and/or denials, increase revenue per visit and achieve a higher level of financial performance.  

Revenue Cycle Assessment Package:

The Revenue Cycle Assessment (RCA) is an onsite comprehensive evaluation of the revenue cycle processes currently utilized for a WMC operating as a Hospital Outpatient Provider-Based Department (HOPD).  The assessment encompasses a review of the Center’s chargemaster, billed charges, collections (and any denial efforts) as well as operational processes such as patient registration, insurance verification, etc. This review includes claim audits, personnel interviews and observation, as well as other means to gather data required to complete the assessment.  

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This package is recommended for clients who have grave concerns about the entire billing, coding and collections processes for wound management services - - and are confident that their current documentation practices have no issues.

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The RCA incorporates and provides:

• Onsite visit (three business days) to conduct the assessment and observe operational practices in the WMC. The first day includes travel to Company location and initiation of the assessment process, if time allows. The second day includes completion of the assessment and beginning of observation activities. The third day is a wrap-up of observation activities, if needed, and a meeting with hospital billing and coding personnel to discuss preliminary findings and any issues or general concerns (from their perspective) with the WMC coding and billing aspects - - this meeting also allows Consultant to confirm the current revenue cycle processes from hospital personnel. Travel home is typically completed on the third day, as time allows.

• Review of WMC billing and coding processes from the time of patient registration to claim submission. This review also includes the patient registration and insurance verification processes.

• Retrospective billing (claim) audits of twenty (20) patient accounts that encompass charge entry, billed charges, collections and any denial efforts, as appropriate.

• Review of WMC Charge Description Master (CDM) and daily charge sheet (superbill), or electronic health record (EHR) billing tool(s).

• Review of financial reports including procedure and visit types billed by the Center in last twelve (12) months.

• Remote (Teleconference) Education of WMC staff (including physicians and hospital billing/coding personnel, as needed) for issues identified by the assessment.

• Followup provided includes a written report outlining RCA findings and recommendations. Followup will also include responses to any telephonic/electronic queries related to the assessment findings, for a period of ninety (90) days after the assessment completion date.

Revenue Cycle Management Support Package:

Once the results of an RCA or Compliance audit have been reviewed and the need for revenue cycle support has been determined, the following services are available as an annual package for ongoing support and audits.

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This package is for clients who want year-round availability of Revenue Cycle Support for hospital billers and coders, personnel and Providers working at the Wound Management Center (WMC). It typically follows the completion of an RCA, or one of the Compliance Audits; however, that is not a requirement - - if this package is solicited within six (6) months of a previous assessment, then the cost of that assessment will be deducted from this package price for the first year.

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management Support incorporates and provides:

• Coding, Billing and Documentation Guidelines that support Evaluation & Management (E/M) and wound debridement services as well as the most common high-cost services (such as HBOT and Skin Substitutes) provided at the WMC.

• Quarterly updates of coverage requirements (as identified by regional LCDs) and billing practices (such as CCI edits) for services provided at the WMC.

• Annual medical chart audit (Revenue Cycle/Documentation) which includes a retrospective review of twenty (20) patient accounts with a focus on supporting documentation, accurate claim submission and payment for services provided at the WMC.

• Annual onsite visit (two business days) and education of WMC staff (including physicians and hospital billing/coding personnel) for issues identified by the medical record audits. If onsite visits are not required, virtual meetings are available as an option.

• Annual review of chargemaster and billing tools utilized for services provided at the WMC.

• Annual review of billing policies and procedures for services provided at the WMC.

• Unlimited Telephonic/Electronic support (email) for revenue cycle queries, as needed.