Specialists

Specialists and VBC Strategy

Engage specialty groups in the discussion around development of a value-based care strategy in collaboration with primary care to deliver more comprehensive, coordinated, and patient-centered care for better outcomes and lower healthcare costs. Our team can support around identifying the specialty groups essential to success in the value-based care journey and develop the right governance structure, education & communication, establish care pathways, utilize technology & data, develop incentives, review & monitor performance, and last but not the least create opportunities for ongoing dialogue and a culture of continuous learning and improvement to adapt to evolving patient needs and healthcare dynamics.

Referral Management

Support the practice to develop a plan through a comprehensive data and workflow analysis to identify the reasons behind specialty referral leakage to external providers. Includes review of data, root causes such as access issues, patient preference, provider preference, primary care to specialty communications, social factors etc., workflows from the point of referral to the completion of referral and feedback look and document the findings to the right stakeholders for prioritization and implementation of strategies.

Documentation and Coding Services

We have a team of certified professional and experienced coders and clinical documentation improvement (CDI) specialists to offer documentation and coding services to assist primary care practices in optimizing revenue cycle management and ensuring compliance with regulatory requirements for both FFS (E&M) and VBC Hierarchical category conditions (HCC). These services involve capturing and documenting patient encounters, medical history, diagnoses, treatments, and procedures in a structured format according to coding guidelines such as ICD-10 (International Classification of Diseases, 10th edition) and CPT (Current Procedural Terminology).

They provide training and support to healthcare providers and staff on proper documentation practices, coding guidelines, and documentation improvement strategies which play a crucial role in the financial viability and operational efficiency of primary care practices. By ensuring accurate and comprehensive documentation and coding, these services help maximize reimbursement, reduce claim denials, capture risk scores, and minimize compliance risks. Additionally, they contribute to improved clinical documentation integrity, which supports better communication among healthcare providers and facilitates continuity of care for patients.

Financial Services

We have a dedicated team of certified coders, billers, CAs to provide a comprehensive set of financial services tailored to the specific needs of your practice which includes revenue cycle management, billing and coding, financial analysis, budgeting, and reimbursement optimization.

These services may involve assessing the practice's financial health, identifying opportunities for revenue enhancement, and implementing strategies to improve financial performance. We also offer support in optimizing billing processes, reducing claim denials, and enhancing coding accuracy to ensure maximum reimbursement for services rendered. By leveraging financial expertise and industry insights, our aim is to empower primary care practices to navigate the complex financial landscape of healthcare and achieve their financial goals while maintaining focus on delivering high-quality patient care.