Physician Practice solutions, maximizing profitability while delivering quality care
Regulatory billing requirements, increased clinical documentation specificity, and incorrectly configured EHR systems are taking valuable physician time away from their primary responsibility of providing patient care. Proper and accurate clinical documentation has always been important, but in today’s shifting healthcare landscape, it is a strategic imperative for the financial health of an organization to have efficient and effective revenue cycle operations.
Managing the complexities of the physician practice end-to-end revenue cycle function requires resources that understand not only physician revenue cycle operations, but also clinical documentation and coding requirements, EHR billing configurations, and physician workflow.
Harmony Healthcare’s Physician Practice solutions include expertise in the following areas:
- Auditing services including coding, billing and charge capture
- Pro-fee coding support
- HCC optimization services
- Outpatient clinical documentation improvement programs
- Problem list repair and management solutions
- EHR point of care coding workflow simplification / optimization services
- Global review and revenue cycle optimization
- Patient registration and insurance verification
- Medical necessity and denial management services
- Clinical documentation, coding and billing education
- MACRA readiness assistance
- Total and partial coding outsourcing
Outpatient CDI and HCC solutions
Harmony’s Outpatient CDI solution incorporates all aspects required to effectively manage the “front-to-back” operational, regulatory and technology requirements needed for physician practice revenue cycle management.
Our outpatient CDI program focuses on:
- HCC data analytics to identify and quantify high-value and high-return physician specialty focus areas
- Problem list repair and management solutions 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
Our consultants will analyze issues from all angles and implement best practices through an in-depth data analytics program structure and education, uniquely designed for your practice and its needs.
This approach helps you:
- Guarantee a return on investment
- Budget neutral investment
- Keep pace with regulatory changes
- Identify clinical documentation and revenue integrity opportunities
- Decrease denials to manage for optimal financial performance
- Improve efficiencies through problem list management
- Maximize quality clinical outcomes
Pro-fee coding, auditing and revenue integrity services
Patient care, data integrity, compliance and reimbursement are at risk when the severity of the illness, treatment provided and mortality rates aren’t documented and coded accurately. Our Pro-fee coding support and auditing services ensure reimbursement accuracy, evaluate compliance adherence and achieve quality assurance.
Our services include expertise in the following areas:
- Coding Quality – We determine coding accuracy and appropriateness of code selection
- Financial Impact – We identify missed revenue opportunities
- Regulatory Compliance – We evaluate overpayment risk and other regulatory compliance risks
- Medical Necessity – We evaluate whether the service’s a patient is provided are medically necessary
- Risk of Mortality and Severity of Illness – We evaluate the patient’s overall severity of illness subclass and risk of mortality subclass accuracy