MediVise is a consulting group providing service to clients across the US. Our professional staff has over 40 years of combined experience in EHR/PM software implementation, practice management, healthcare billing, and medical policy.
Frequently Asked Questions
are we leaving any money on the table?
Medical practices work hard to streamline workflows, improve processes, and achieve maximum patient satisfaction. Revenue cycle review can help to ensure that work is reimbursed by payers.
are we billing medicaid/medicare correctly?
There are numerous federal and state regulations governing billing claims to Medicare and Medicaid. There are guidelines that apply to all clinic and provider types as well as those that apply only to community health centers (FQHC or RHC), home health agencies, and nursing homes. MediVise's revenue cycle review will help your practice achieve billing compliance with all applicable guidelines.
are we collecting the most we can from insurance ?
Managed care contracts should be reviewed and fee schedules renegotiated periodically. Additionally, claims must be reviewed to ensure that they are paid in accordance with established fee schedules. MediVise revenue cycle review uncovers errors in claims payment and can provide the tools to help your staff renegotiate unfavorable rates.
do my providers document correctly?
Clinical documentation improvement is a recent CMS (Centers for Medicare and Medicaid Services) focus area. Practices can be subjected to intense audits and massive fines if their documentation is incomplete or does not support claims billing. MediVise chart auditing services will help your practice achieve compliance with all applicable guidelines.
aRE MY ORGANIZATION AND PROVIDERS ENROLLED AND IN-NETWORK WITH MAIN PAYERS IN MY AREA?
Our credentialing team can process new provider and organizational enrollments for government and commercial payers (including dental and behavioral health) as well as maintain current enrollments and negotiate more favorable contracts with managed care payers.
our organization is implementing a new electronic health records Program. where do we start?
Conversion and/or implementation of new EHR/PM systems can be overwhelming for administrators, providers, and support staff. A detailed project plan and experienced leadership are required for successful software implementations. Our consultants specialize in software implementation projects and can provide onsite support for providers and support staff throughout the training process.
are we billing incident-to or locum tenens correctly?
Incident-to billing is the practice of billing claims for outpatient services provided by a non-physician practitioner (NPP) under the billing information associated with a physician. Locum tenens physicians are physicians who work in place of the regular physician when that physician is absent. Both practices result in claims that are billed with names and numbers other than those of the rendering provider listed. Both locum and incident-to billing are complicated and frequently misused. MediVise chart audits can help uncover errors and correctly navigate these processes.