I hope that this issue of the BESLER Beacon finds everyone well and that spring is making its appearance wherever you may be. We can hear the sounds of baseballs careening off bats in the far off distance so we know that warm, sunny days are close at hand. While we all look forward to enjoying the spring and summer, we still have many challenges facing us as healthcare professionals and we know that each of you is working harder than ever to meet those challenges. At the same time, we at BESLER are continuing our unrelenting effort to find new solutions for our clients that bring unmatched results and the ROI that you need to help you through these tough times.
Key among new solutions is our B-VerifiedSM
software tools that encompass the knowledge, expertise and processes that we have developed over many years. These include our BVerifiedSM -Transfer DRG
and BVerifiedSM -IME
solutions that take our proprietary technology in place it in your hands. These tools afford our clients the opportunity to internalize currently outsourced processes using the most effective and compliant approach in the industry. The Transfer DRG tool automates the entire identification process and provides the comprehensive follow-up and tracking mechanism that is necessary to validate all claims. The Medicare Advantage IME tool gives you the ability to systematically identify “shadow bill” claim exceptions and new opportunities. Both of these tools can create internal efficiencies and reduce costs, thereby increasing your overall ROI. Of course, the BESLER team is still available to you to create innovative hybrid solutions based on your hospital’s specific processes and needs. You can learn more about these powerful tools at http://www.besler.com/bverified.htm
With healthcare reform implementation is picking up steam, BESLER believes it is critical that hospital providers do not underestimate the importance of the Medicare Cost Report. Often it seems that the Cost Report is decreasing in consequence but in reality it remains the primary source of Medicare provider cost data and, therefore, will be partially relevant to most, if not all, future Medicare reimbursement determinations. BESLER maintains a team of experts that can prepare or scrutinize your prepared cost report to identify potential erroneous, misclassified or missing reported data that could have a deleterious impact on your reimbursement in the future.
When it comes to challenges, hospitals are facing many in the current healthcare environment. With the myriad demands placed on your revenue cycle team by the numerous agencies and companies investigating possible overpayments, there is precious little time left to ensure that the hospital is getting properly paid for all of the care it provides. BESLER understands this and assists many of our clients with a variety of revenue recovery efforts that directly impact the bottom line. These services range from the Transfer DRG and IME opportunities noted above to retrospective denial and workman’s compensation analysis, managed care payment reviews, DSH second sweep reviews and charge capture/documentation audits. If you would like to discuss your exact needs in terms of revenue recovery, we would be happy to craft a package specific to you.
I believe that one of the main objectives that every provider must have in order to achieve improved overall performance in the new healthcare environment that is being ushered in with healthcare reform is the true integration of financial and clinical performance. Whether you subscribe to the Accountable Care Organization (ACO) model or not, there is no denying that the concepts on which the ACO model is based will become the basis of future care delivery and business models. A great place to begin in establishing this integration is with the challenges being faced right now. In order to minimize the potential for future overpayment and recovery efforts, we work closely with our clients to implement solid revenue integrity and compliance processes and a key component of our approach in this area is our Clinical Support for Revenue Assurance and Compliance. BESLER can assist you in bringing to the table the appropriate clinical resources that are well-versed in the complex coding and documentation issues that are so often at the root of billing and compliance issues. The best defense against the constant onslaught of recovery efforts is to build a solid billing process that truly integrates the necessary clinical components.
I always like to take the opportunity to thank our clients for the opportunity to work with you in accomplishing your hospital’s goals. We appreciate the fact that you have limited consulting dollars at your disposal and therefore we work extremely hard to make certain that we produce the best possible return for your investment. This is why we have gone to great lengths to share the risk with you by creating many services that you pay for only when results are produced. That is our way of demonstrating our commitment to a true partnership with you.
So, although the challenges are many and time is limited, take the time to get to a ball game this spring (or a round of golf or just a nice long walk on a warm day). The time invested can well worth it in terms of how it helps you put things in perspective and charge up the batteries a bit!
Brian P. Sherin, FHFMA