Our Services
WE’VE BEEN SPECIALIZING IN HEALTHCARE REIMBURSEMENT CONSULTING FOR OVER 20 YEARS.
We work with small to medium sized physician practices.
Most recently we have been working with small to medium sized physician practices and the entities that support them, such as attorneys, billing and/or coding companies, accountants, etc.
Experience with governmental payors.
Our considerable experience with governmental payors and large institutional providers and the entities that service them brings a high level of insight in supporting work in these areas (such as Medicare audits).
- High level end-to-end revenue cycle audit.High level end-to-end revenue cycle audit. This review takes a small sample of services provided. Each service is followed from appointment to final disposition to identify any potential revenue cycle concerns.
- Establish and implement Corrective Action Plans (CAP).
- Targeted internal audits.Targeted internal audits. There are many reasons to perform a targeted (preventative) audit, including but not limited to concerns over individual internal or billing company staff; specific procedure code audits; reimbursement practices for a specific payor; any other area of specific concern.
Billing and Audit Support
Medicare and other payors are auditing provider services with increasing frequency. Responses to these audit activities should always be carefully reviewed to ensure enough, but not too much, documentation is submitted. We support physicians in minimizing the negative impact of such audits at every step of the process. Note there may be times when referral to legal representation is recommended.
Coding Audits/Chart Reviews
Coding reviews ensure a provider is maximizing both reimbursement and compliance by properly documenting and coding for services rendered.
- Identification of the top procedures preformed
- Selection of 5-10 procedures to review in detail
- Collection and review of all documentation supporting those procedures, including office visit/procedure notes
- Written report of findings, with specific attention to accuracy of documentation and coding to support the services performed
- Meeting with provider(s) to review report and answer any questions
- Implementation of internal audit program
- Conduct regularly scheduled coding and reimbursement reviews
- Chart reviewThis service takes charts for a variety of services and reviews them from a wide perspective, including documentation improvement suggestions, compliance recommendations, identification of potential areas of concern, payor specific considerations, bundling, etc. It includes a written report, and customized provider education sessions, where appropriate.
- Customized training of staff and education of providers
- Develop and organize library of coding reference materials
- Coach staff on effective communication strategies (particularly important with on-shore/off-shore arrangements)
- Value-based staff developmentValue-based staff development can help your staff reach that next level to deliver enhanced value to clients (this service is provided to medical practice support partners such as billing companies)
- Services can be provided directly or as train-the-trainer, and face-to-face or remotely
Coding Training and Provider Education
We work closely with both on-shore and global organizations to train coding staff, perform operational analyses, and fine tune internal training protocols.
Operational and Staffing Assessment
We work with the provider and staff to identify areas to enhance the efficient and effective operation of the Practice.
- Current staff is evaluatedCurrent staff is evaluated and recommendations are developed and presented to the provider. Recommendations typically include training current staff, or hiring and training new staff. The latter incorporates all aspects, including development of job descriptions, interviewing, etc.
- Full service operational maximizationFull service operational maximization is a retainer based relationship with on-site visits plus emails and phone calls as needed. Our focus is to review all business aspects of the practice and make recommendations to improve your income and efficiency. On-site services provided by a Certified Healthcare Business Consultant.
- Detailed review and update of physician’s online presenceDetailed review and update of physician’s online presence and patient referral sourcing to enhance the patient screening process and help attract the right new patients
- Increase your cash flow and identify hidden revenue opportunities
- Reimbursement analysis of potential payors to participate with (based on preferred procedures performed by physician)
- Reimbursement maximization services to ensure all available revenue has been received for services provided, including denied and underpaid claims
- Evaluate in/out of network participation
- Identify streamlined payor processes (many of them want to trim expenses too!)
Reimbursement Consulting
Ensuring maximum reimbursement available for each patient visit is more than just submitting clean claims. Our periodic review of your revenue cycle will:
Privacy & Compliance 101 Packages
We can help provide you with the basics. Customized HIPAA Privacy Policy for YOUR practice to inform your front desk staff, who are on the front lines of patient communications.
About Habanero Inc.
Habanero Inc. is your Medical Practice Rx. Habanero is based in New York and serves clients across the United States and off-shore. We offer Healthcare Reimbursement Consulting Services that maximize provider reimbursement while maintaining the letter, spirit & intent of compliance rules.
Contact
(631) 244-5661
info@habaneroinc.com
Certifications & Qualifications
Certified WBE in NYS, NYC, Nassau County, Suffolk County, Missouri, and MTA DBE
- – Certified Professional Coder
- – Certified Professional Medical Auditor
- – Certified Healthcare Technology Specialist – Trainer