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Overview. AmeriVeri CR: provides the latest, proprietary, code verification technology; identifies employer savings of 3-8%; operates on performance-based pricing; does not create “noise” in your system or slow down payments;
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Overview • AmeriVeri CR: • provides the latest, proprietary, code verification technology; • identifies employer savings of 3-8%; • operates on performance-based pricing; • does not create “noise” in your system or slow down payments; • does not change anything – AmeriVeri CR is a secondary process and works with all software systems; • provides a choice of free, secure demonstrations: • 6 month review or 3 month real-time test.
Performance-based Pricing AmeriVeri CR fee based on percentage of net savings No financial risk of any kind All appeals handled at no charge by AmeriVeri CR Savings can become a significant new source of revenue for Employers…see the chart
Important Notes Code Verification clinically sound and supported 1% provider resubmission rate 1/10th of 1% provider appeals AmeriVeri CR provides “turn-key” program and professional assistance at every step
The System Uses Application Software Provider (ASP) platform Interfaces with all claims administration software Identifies rejections by ANSI reason Uses 1.4 million edits of Current Code Scrubs each claim twice and is constantly reviewed by Coding experts representing over 50 years total experience.
Engine Constantly Updated Quarterly updates: HCPCS codes from CMS CPT codes from AMA ICD-9-CM codes from DHHS CCI codes from CMS Changing / evolving payer practices Changing technologies Clinical practice patterns Medical society-driven clinical protocol
Data Security / PHI Secured File Transfer Protocol (SFTP) 128-bit Secured Socket Layer (SSL) encrypted connection (Verisign approved) Meets or exceeds all HIPAA requirements Utilizes the highest level of security available System housed in a 24-hour security, technical support & climate controlled facility
AmeriVeri CR Tech Team Patti Merdian Experience 12/05- present: AmeriVeri CR/Medical Claims Review, LLC President/SVP R&D 05/00- 05/09: Bill Dunbar and Associates, LLC Regional Director of Client Services 07/99 to 8/00: Indiana University School of Medicine Audit Facilitator/ Billing office manager 3/97 to 6/99: JWM Neurology Clinical Operations Manager 06/95 through 2/97: New River Valley Ear, Nose, and Throat Associates, PC Office Administrator Certifications:CPC, CCS—P, CCS, CPC—H, CEMCCertified Professional Coder (CPC), American Academy of Professional CodersCertified Coding Specialist (CCS-P), American Health Information Management AssociationCertified Coding Specialist- Hospital (CCS), American Health Information Management AssociationCertified Professional Coder- Hospital (CPC-H), American Academy of Professional CodersCertified Evaluation and Management Coder (CEMC), American Academy of Professional Coders Extensive experience with CPT—4, ICD—9—CM, HCPCS Level II, Chargemaster, Chargesheet, ICD-9-CM database, Explanation of benefit/payment, CMS 1500 and CMS 1450 claim forms, and other unique forms Extensive experience with various billing rules and regulations (e.g., Commercial, Government, Workers’ Compensation), contract adherence, and general practices on the billing side of organizations Memberships/Affiliations: American Academy of Professional Coders (AAPC) American Health Information Management Association (AHIMA) American Medical Association (AMA) Medical Group Management Association (MGMA) National Association for Occupational Healthcare Providers (NAOHP) Twin County Regional Hospital Foundation Board member AAPC Local Chapter – Galax, Virginia (Founder, current President) Education:Bachelor of Arts in Life Sciences/ Spanish minor, Indiana State UniversityMaster of Science, certificate program, Indiana University (audited for additional college credit)Master of Arts in Education, thesis pended, Virginia Tech
AmeriVeri CR Tech Team • Steve Reed • Summary • In-depth experience in strategic planning, business planning, and budgeting • Effective operations manager with proven experience in improving financial performance, employee satisfaction, patient satisfaction, quality and patient safety • Experienced managed care negotiator & contractor • Effective business developer with in-depth experience in planning, designing, and implementing numerous hospital and healthcare projects, programs and services • Experienced physician recruiter • Directed the development of a $200M master facility plan and hospital replacement project • Assisted in creating a separate joint venture partnership for a hospital-based ambulatory surgery center • FACHE: Fellow, American College of Health Care Executives Experience • 06/07 to present: AmeriVeri CR/Medical Claims Review Sr. Consultant, Operations • 03/06 to 05/07: Lant & Associates, Inc. Executive Director • 02/01 to 02/06: Union Hospital Health Group Chief Operating Officer • 04/95 to 11/00: Women’s Hospital of Indianapolis President & CEO • 03/93 to 04/95: Terre Haute Regional Hospital Chief Operating Officer • 07/89 to 02/93: Charter Medical Administrator • 11/88 to 07/89: Charter Peachford Hospital Assistant Administrator • 04/85 to 11/88: Union Hospital Vice President, Professional Services • 04/84 to 04/85: LaPorte Hospital Director, Human Resources • Education • Bachelors, Business Management Indiana State University, May 1981 • Masters in Health Administration Indiana University, December 1983 • Professional Activities • Fellow, American College of Health Care Executives, Adjunct Faculty, IUPUI, Indiana Wesleyan University & Harrison College, Deacon, First Baptist Church, Past Mentor, IUPUI MHA Program & Suburban Health Organization, Past Member, Southern Indiana Regent’s Advisory Council – ACHE, Past Chairman, Secretary and Board Member , Indiana Health Centers, Past President, Visiting Nurses Association of the Wabash Valley, Past Member, Board of Directors, Indiana Hospital & Health Association (IHHA), Past Chairman, Council on Resource Management – IHHA, Past Member, Board of Directors, Zionsville Rotary Club, Past Chairman, Medical Services Group, Wabash Valley United Way
AmeriVeri CR Tech Team Marsha Putt Significant national management experience in customer service from the Corporate automotive sector; Management of dealer and client business relationships for domestic and foreign automotive manufacturers; Developed training initiatives on customer satisfaction and retention; Exceptional ability to develop, facilitate and integrate business programs with varying levels of clients and internal teams. Extensive background in strategy, program management and Six Sigma-based continuous improvement; BS in Industrial Engineering Technology from Purdue University.
For More Information Visit us on the internet at www.AmeriVeri.com Or contact: Patti Merdian President 276.233.2144 pm@AmeriVeri.com Jim Baughman CEO 317.224.9074 jb@AmeriVeri.com Marsha Putt VP, Client Services 847.544.8007 mp@AmeriVeri.com Martin Amberger Director, Marketing Communications 317.696.0615 ma@AmeriVeri.com