Colorado TriCare is Changing!
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Fee-For-Service Reimbursement
It is still out there alive and well.nnDon’t take your eye off the ball when it comes to contracting with your payers.nnManaged Care Contracting is a continual process. It should be done constantly and consistently. For a well–managed process you should be seeing 4-5% increases every year.nnWhat is it worth? How much did you receive in total reimbursement last year? Multiply it by 5%. Is it worth it? Of course it is!n
Managed Care contracting is one of those 20 to 1 Return on Investment services we do and do well!
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About R. Todd Welter • MS, CPCnFounder and President of Welter Healthcare Partners
nMr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment. Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.
General Surgery Case — Surgical Coding Series: WHP Coding Conundrums
As part of the new coding format for our newsletter, Welter Healthcare Partners is excited to offer you a new surgery coding series in which we want to help you! The 2nd week of every month we will highlight a complicated surgical case. This week we are highlighting a general surgery case. We want to hear from you! If you have a complicated surgery case and need help with coding, please upload the operative note by clicking on the link below. Remember to remove ALL patient protected health information and organization identifiers. Welter Healthcare Partners will not use any medical records submitted in which PHI is not removed and protected. Click Here To Submit Redacted Surgery Case StudynnPreoperative Diagnosis:nRecurrent colorectal cancer at the anastomotic site.nnPostoperative Diagnosis:nRecurrent colorectal cancer at the anastomotic site.nnProcedures:n
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- Partial colectomy with end colostomy.
- Small bowel resection with primary anastomosis.
- Flexible sigmoidoscopy.
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nIndications: The patient is a 54-year-old gentleman who presented with colorectal cancer over a year ago. He had a resection and was just finishing chemotherapy and had some GI problems that necessitated a colonoscopy. He was found to have a stricture at the anastomosis, which was biopsied and found to have recurrent colorectal cancer. Risks and benefits were discussed with the patient who understood and agreed with the treatment plan.n
Free Revenue Assessment Available with Welter Healthcare Partners Associates
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- Analysis of charges, payments, and write-offsn
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- What we need: 12-month report (reported by month)
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- Provider Coding Analysisn
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- What we need: List of all CPT codes used and number of times reported (12-month report, by provider)
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- Fee Schedule Analysisn
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- What we need: List of all CPT codes and fees (what you charge)
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- Insurance Contracts Analysisn
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- What we need: List of major insurance contracts, rates, and when last negotiated
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nTo set up your free revenue assessment, please contact Connor Beer, Director of Sales, at 720.879.3621 or cbeer@rtwelter.com.nnFor more information about Welter Healthcare Partners and our services, please visit our website at www.WHPelter.com.
MIPS and MACRA
Another set of scary acronyms! As with all of these roll outs, take it one step at a time! It is really not scary IF you have been keeping up on coding and documentation and have a reasonably up to date EMR. There is a lot of help out there and as always we are ready willing and able to do the same.nnThe absolute worst things to do: Bury your head in the sand and hope it will go away. It is not going away.nn nn nn
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About R. Todd Welter • MS, CPCnFounder and President of Welter Healthcare Partners
nMr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment. Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.