Simplify physician workflow and enhance documentation quality for optimal reimbursement

Managing the physician practice revenue cycle, requires resources that understand not only clinical documentation requirements and risk adjusted reimbursement coding, but also physician operations, EHR billing configurations, and physician workflow.

HCS Consulting’s Physician Revenue Performance Improvement solution is more than just deploying outpatient clinical documentation improvement (OP-CDI) specialists, it is centered on data analytics, physician end-to-end workflow optimization, and leveraging technology for improved efficiencies and outcomes.

IMPROVED DENIAL MANAGEMENT

Enhance clinical documentation and processes, reduce denial rates and prevent future denials, mitigate lost revenue, and retain future revenues.

OPTIMIZED REIMBURSEMENTS

Identify clinical documentation and revenue integrity opportunities to maximize reimbursement.

IMPROVED QUALITY OF PATIENT CARE

Optimize documentation and coding tools to simplify workflow and maximize quality clinical outcomes.

Approach

Our approach manages the revenue integrity of the end-to-end physician point-of-care coding process. Analytically driven and physician centric, our consultants focus on managing the HCC and AWV population management process.

ASSESSMENT

Analytics – Identify systemic opportunities for process assessment, interviews and medical record review
Technology – Assess the EHR physician point-of-care coding configurations, structure, etc.
Operations – Evaluate physician point-of-care coding, documentation, charging process etc.
Functionality – Determine OP-CDI structure, process flow, staffing, education plan etc.

IMPLEMENTATION

Infrastructure Plan – Build and implement OP-CDI technology, personnel and processes
Operational Plan – CDI processes, technology platform, physician feedback, and measured outcomes
Education Plan – Role based education for physicians, CDI team, leadership on CDI, coding, analytics, EHR tools etc.
Analytics & Reporting Plan – Implement analytics process, educate and operationalize

MONITORING

Scheduled conference with CDI team to proactively co-manage the OP-CDI program
Ongoing monitoring / coaching to ensure outcomes are progressive and team continues to develop
Outcomes analysis to provide consultative analysis and interpretation of outcomes

Service

HCC data analytics to identify and quantify high-value and high-return physician specialty focus areas.

Problem list repair and management to streamline physician workflow and eliminate pre-visit HCC reviews, multiple problem list confusion, and conflicting documentation.

Optimized physician EHR documentation and coding tools to simplify physician workflow, enhance documentation quality, and promote appropriate coding for optimal reimbursement.