Management Consulting

Our consultants understand the importance of integrating systems, structure, strategy, culture, people, skills, and work processes based on an organization’s core values and goals. Each of these is considered when operational and temporary (interim) management-consulting engagements commence.

Strategic Planning Facilitation

For organization leadership. Designed to introduce planning techniques to new Boards and Administration and to assist Boards and Administration in updating old and out-of-date plans.

Documentation Improvement Services

Improving reimbursement requires accurate coding based on comprehensive physician documentation that supports the care provided to the patient. We work closely with your utilization/case management staff, coding professionals, and physicians on proper documentation techniques. In addition, we have professional physician advisors to work directly with your physicians, if necessary.

JCAHO preparation

One department or hospital-wide. No need to tie up one of your management team members when our professionals who have "experienced" the survey before can facilitate organization preparation.

• Initial readiness assessment
• Corrective Action Plan development with hospital management staff
• Action plan monitoring and "prodding"
• Model sharing to avoid starting from scratch
• Tips from prior surveys
• Staff prompting
• Hospital Policy and Procedure review and updating
• Medical Staff compliance
• Bylaw, Rule and Regulation review and modification

Staffing Analysis

Healthcare organizations must find innovative ways to deliver care efficiently while maintaining high quality standards for patient and customer service. Today no provider can be "average". Therefore, we do not expect your staffing needs to be the "average" of your peers. Our staffing analysis is not "cookbook" based. Our consultant reviews the unique characteristics of your organization, studies the flow and load of work, assesses the demands throughout the day and week and, then, based on this data, recommends the staffing that will be able to meet the demands.

During any staffing analysis, we consider the effectiveness of the management structure and work flow bottlenecks related to physical layout, interdepartmental coordination, and organization policies and procedures. From this analysis, we are able to project staffing protocols and monitoring techniques, propose productivity standards, develop incentive plans, and identify training needs. We can assist your management staff in any reengineering efforts and change agent facilitation.

Recruitment

Our firm will serve as your recruitment arm to find a qualified Health Information Manager or Director if we are serving as your temporary HIM Manager.

Information Management Services:

Transcription quality assessment

Routine evaluation of the accuracy of transcribed reports is imperative to ensure against missing essential data elements necessary to defend the physician and hospital against potential lawsuits. As part of any department's quality assessment program, evaluating the quality of the work performed by professional transcribers will allow management to address common errors and omissions, identify training needs, and measure the performance of staff members.

Space analysis

Out of space? Planning a new department? Attempting to determine space needs for the future? Our consultants will work with you to design a workflow that is logistically sound. Our space planning affiliates will identify equipment and furnishings to meet your needs.

Policy and Procedure Manual updating and/or preparation

As new regulatory and accreditation changes are introduced, policy and procedure manuals must be updated. Our consultants review each position in the department against the current procedure for the position and update the description with the involved staff member. Policies are updated based on hospital or organization, JCAHO, AOA, CMS, HIPAA, OIG, and state regulations.

Managed Care Services:

First Class Solutions, Inc. ^sm team of managed care professionals includes professionals with staff and IPA models and PPOs. Our services include, but are not limited to:

• managed care network development - identification of physicians, hospitals, and other providers; contract procurement; train staff in provider relations activities;

• credentialing services – serving as temporary staff for your organization and under your organization’s credentialing leadership, we will obtain credentialing information; perform primary verification; query National Practitioner Data Bank, if appropriate; assist you establish credentialing operations;

• temporary management - as vacancies arise, senior management may desire an "outside" opinion of a department's operation. Operational assessments and temporary management of a department can yield improvements in overall workflow by allowing our consultants to be your "change agents";

• clinical record systems - for staff models;

• data collection - from chart audits, billing systems or other data abstraction sources;

• claims auditing - review of claims data accuracy; correlation of services with diagnoses treated; potential fraud identification; provider profiling; on-site audits of documentation versus services billed,

• clinician coding validation - codes submitted with claims versus services documented;

• medical management - utilization structures, quality assurance activities, models, standards;

• provider selection - provider auditing and utilization/quality assessment including external physician review of provider practices;

• provider training – our clients have found it helpful to provide clinicians with coding training prior to initiating sanctions to allow clinicians/providers to improve their coding and/or documentation practices;

• special projects – our staff are willing to come to your site or work at ours to perform special projects. Do not hesitate to contact us to discuss your needs.
  

Other Services:

Inservice training program:

• Release of Information and Confidentiality
• HIPAA
• Fraud Issues

Customized Software Development and Automation Assistance:

• Customized Software: Chart tracking, Correspondence Management and Incomplete Record Management

• Facility-wide system design and hardware supply

• Network Support

• Web site Design and Hosting

• eCommerce services

Physician Office Management Services:

• Superbill Updates-Annually the American Medical Association and CMS revise the required coding systems (CPT-4 and ICD-9-CM). Lost revenues and delayed payments will result from the use of outdated codes. Our consultants will review and update the codes on your existing Superbill form and assess your service mix to determine if any new services should be added to enhance your billing practices;

• Compliance, coding and documentation studies-CMS indicates that it will audit 20% of all providers billing Medicare. CMS's audit focus will be to find documentation that is insufficient to justify codes for services billed. Fiscal penalties for failure to have adequate and/or complete documentation to support past billings can bankrupt a practice. Our consultants use tested abstracting and analysis forms to determine whether your documentation meets CMS's stated documentation requirements;

• Temporary staffing;

• On-site coding education is provided for the coding staff and documentation training is conducted for the professional and physician staff; and

• Record maintenance and storage evaluations including determining file systems needs.

• EHR evaluation and implementation assistance including use of optical imaging systems

HIPAA Readiness and Compliance Assessments

Our services will be as broad or narrow as our client requests and may include:

Compliance Readiness Assessment of HIM Department

This assessment includes, but is not limited to, a review of the following department items and activities:

Clinical Pertinence, Closed or Open Record Studies, and Record/Chart Audits

Review of records for designated documentation elements, completeness, and/or other special studies.

Operations Review (Operational Assessments):

Department-wide

The Operational Assessment is an extensive review of all functions within the Health Information/Medical Records Department and a brief review of the Business Office, Patient Financial Services, Admitting Department and other related functions as they pertain to demographic capture and clinical record processing. Our comprehensive operational assessments include a review of medical records processing activities from initial chart receipt and completion through coding, abstracting and final reporting, focusing on the processes and backlog avoidance.

Operational Reviews are conducted by experienced Health Information Professionals who will thoroughly review each aspect of your daily operation and the HIM departments effectiveness in the revenue cycle.

Systems Review

Analyzing all health information (medical record) service systems from admission to permanent filing providing detailed reports of our observations and proposed solutions. We examine chart control, access and storage, tracking systems, assembly, coding, DRG and APC assignment, compliance, abstraction, management, organization, information collection and dissemination, chart completion, and companion functions of utilization review, performance improvement/quality management, risk management, denial management and medical staff credentialing/privileging.

Health Information Services Procedures and Policies

Reviewing existing procedures and policies to offer guidelines and standards for improved procedures and increased productivity.

Revenue Cycle Enhancement

Reviewing existing data and information flow from admission to record completions including attestation completion to identify opportunities to improve lag time from discharge-to-code. Working with staff involved in each step to identify barriers to achieving optimal completion intervals. Assisting supervisory staff with self-analysis techniques and with initiating concise monitoring and correction mechanisms to improve coding accuracy and timeliness, reduce claim denials, and accounts receivable management.

Training

Demonstrating, through on-site seminars, workshops and inservices, appropriate methods of assembly, analysis, release of information handling, coding and incomplete record control.

Department Relations

Observing system wide relationships and interchange of information between key departments and the health information department, with the goal to improve the timeliness of bill preparation and reduction of days in accounts receivable.

Abbreviated or "Brief" assessments can be performed to focus on a specific function or issue.

Service-Specific: Transcription

This comprehensive transcription assessment and evaluation includes comparing on-site/off-site and outsourcing transcription support options, operational reviews, dictation and transcription equipment needs, developing RFPs for obtaining system/equipment quotations and summarizing competitive bids received, and quality of work assessments.

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