Regulatory and Practice Management Services

1. Daniel L. Johnson, CPC, CPC-H Regulatory and Practice Management Services

2. Practice Management Services • Total Practice Management • Practice Evaluations • Revenue Cycle and Fee Schedule Analysis • Strategic Planning • Business Plans • Practice Valuations • Managed Care Contracting • Presentations

3. Practice Management ServicesTotal Practice Management Description: For the approximate cost of a full-time employee, MMHSI can oversee and manage the day-to-day operations of a medical practice.

4. Practice Management ServicesTotal Practice Management • Consulting and management support of a medical practice to include but not limited to the processing of insurance claims, accounts receivable, accounts payable, and other reporting as may be required by the physicians. • Monthly on-site visits by a member of the Consulting Staff of MMHSI for oversight. Monthly reporting on the operations of the office will be provided. • Consulting support for CPT/ICD-9/Medicare/Medicaid and other Third Party Payers as related to physician billing.

5. Practice Management Services Practice Evaluations Description: Assesses practice operations and management. An on-site assessment of 2-3 days is necessary and written report of findings and recommendations are provided.

6. Practice Management Services Practice Evaluations • Assess billing operations, collections, and accounts receivable; • Coding and documentation review; • Comparative Profile Analysis • EO(M)B Review (review of denied services) • Patient Mix Analysis • Patient Flow • Staffing Analysis • Regulatory Compliance Review

7. Practice Management Services Revenue Cycle and Fee Schedule Analysis Description: Review billing, collections, and accounts receivable process and makes specific recommendations for improvement. Current Fee Schedule is reviewed and compared to our extensive database of physician fees. Recommendations are made to change charges to current market levels.

8. Practice Management ServicesStrategic Planning • New Business Structures • Develop New or Updated Management Teams • Enhance your Business • Develop New Revenue Streams

9. Practice Management ServicesBusiness Plans • New Business Ventures • Obtaining Capital Investment • New Practice Startups

10. Practice Management ServicesPractice Valuations • Valuations of Hard Assets • Valuations of Intangible Assets (Good Will) • Evaluation of Regulatory Compliance for Valuation Purposes • Evaluation of Cash Flow and Collections • Evaluation of Staffing and Expenses • Assign Dollar Value to Your Practice

11. Practice Management Services Managed Care Contracting • Evaluation of Current Contracts • Evaluation and Negotiations of Fee Schedules • Evaluation and Recommendations for Future Contracts • Direct Contracting • Capitation Evaluation

12. Practice Management Services Presentations • Practice Evaluations • Revenue Cycle Analysis • Organization Management • Managing and Motivating Staff

13. Regulatory Compliance Services • Medicare/Medicaid/Third-Party Payer Audit Defense • Voluntary Compliance Programs • Individual and Corporate Integrity Agreements • Voluntary Disclosures • HIPAA Compliance Programs • OSHA Reviews/Training/Compliance • Research and Coverage Analysis • New CPT Development • Legal Assistance and Support Services

14. Regulatory Compliance ServicesAudit Defense • Consulting Services Related to Disputing Overpayment Demands • Statistical Analysis • Fair Hearing and Mediation Representation • Administrative Law Judge Hearing Assistance • Attorney Support Services • Research • Audits • Other Analysis as Needed

15. Regulatory Compliance ServicesVoluntary Compliance Plans • Establish Voluntary Program Designed to Limit Audit/Fraud& Abuse/Whistle-Blower Cases • Custom Program Designed for Your Practice/Business • Meets OIG Compliance Guidance • Annual Auditing and Monitoring

16. Regulatory Compliance ServicesIndividual and Corporate Integrity Agreements • Recognized as Independent Review Organization by the OIG • Statistically Valid Design and Auditing • Annual Reporting and Monitoring • Customized Compliance Program to Meet Integrity Agreement Goals

17. Regulatory Compliance Services Voluntary Disclosures • Mediation with Payers • Confirmatory Audits • Corrective Action Plans • Auditing and Monitoring to Assure Compliance

18. Regulatory Compliance Services HIPAA Compliance Programs • Compliance Manual • Training • Implementation • Form Development • Dispute Resolution

19. Regulatory Compliance ServicesOSHA Reviews/Training/Compliance • Initial Safety Evaluation and Report • Safety Manuals • Blood Borne Pathogen Manuals • Training • Complaint Investigation and Resolution Management

20. Regulatory Compliance ServicesResearch and Coverage Analysis • Complex Coding and Reimbursement Issue Analysis • National and Local Coverage Decision Research and Analysis • New or Revised Coverage Determination Development

21. Regulatory Compliance ServicesNew CPT Development • Direct Liaison with AMA CPT Advisory and Editorial Panel • Single Specialty Society Involvement • Research and Plan Development • Presentation and Follow-up Services

22. Regulatory Compliance ServicesLegal Assistance and Support Services • Fraud and Abuse Defense working with Legal Counsel • Administrative Law Judge Hearing Assistance • Expert Testimony • Auditing • Research and Analysis