A comprehensive approach to reimbursements
We assist commercial payers in implementing and maintaining reimbursement systems, including payment systems and payment methodologies. Our comprehensive approach to reimbursement methods includes the use of experienced consultants, clinicians and proprietary software to model and manage inpatient, outpatient, and professional reimbursements.
We identify reimbursement opportunities for organizations like yours through a combination of established methodologies, automated analysis tools and industry know-how. Our consultants provide a full spectrum of financial planning and strategic consulting services employed by payers / insurers nationwide. Our services include:
- Designing, evaluating and enhancing new and existing provider reimbursement systems.
- Benchmarking and modeling of Medicare payment methods for inpatient, outpatient and physician fee schedules
- Billing and payment contract policy development
- Providing claims-processor education via custom designed training plans
- Developing a thorough systems audit and workflow review to identify areas of vulnerability
- Delivering provider contracting support and education