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Medical practitioners strive to provide the highest quality care to their patients. Previously, physicians worked in a fee-for-service environment with less emphasis placed on the quality. The challenges included rejections, denials of payment, random audits by the insurance carriers or governmental agencies and other straight-forward administrative intricacies. However, in today’s healthcare landscape, with the shift to the value-based healthcare model, providers are required to find the balance between providing exceptional quality to patients and high satisfaction score, detailed clinical documentation, coding and data integrity between many systems, while still being mindful of the costs incurred to obtain this.
A significant focus of healthcare providers’ efforts currently falls on quality initiatives and reporting. These initiatives measure physicians and their staff by practical care and interpersonal skills. Typically, practical care quality is measured using clinical documentation and diagnostic/procedural coding found in administrative databases or electronic health records (EHR), whereas interpersonal quality is measured using patient surveys (also known as ‘patient satisfaction score’ or ‘HCAHPS score’).
The patient remains the first and foremost priority, but now it’s also essential for physicians to maintain high-quality scores and meticulous documentation in order to earn the reimbursement and quality ratings that enable the health systems and providers to continue to take care of the patient.
Challenges in revenue cycle and generally dealing with the insurance plans, new regulations for coverage determinations, data security and management standards, changes in coding further complicate the task.
AJHC Advisory Team assists hospital-based practitioners, medical groups and individual providers to find balance and restore confidence through education, online or in-person one-on-one or a group training, as well as hands-on support. Our team is known to deliver the valid message of “work smart not hard” to the healthcare practitioners, where knowledge and automation meets quality of patient care, improved satisfaction score and optimized revenue, while preventing the providers from a burnout caused by chaotic reactive approach.
- Coding and compliance education
- Clinical documentation improvement (CDI)
- Procedure coverage reviews
- Templates assistance
- Performance audits for opportunities and compliance
- RVUs and revenue optimization
- Credentialing and contracting support
- Patient satisfaction score improvement
- Internal staff training
- Assistance with external audits and corrective action plan (OMIG, RAC, OIG, etc.)
- Performance benchmarking and best practices
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AJHC Academy
Paid content/ courses for deeper insights and hands-on training for better success and efficiency.
In-Person Training
Virtual or face-to-face One-on-One and Group couching for your organization’s provider and staff teams.
Hands-on Support
Outsourced Project/task Delegation and/or Management in most aspects of healthcare administration.