Apr 21, 2017 | Uncategorized
The staff is everything! We cannot do it without them.nnOur (and your) most valuable asset is the staff, their abilities, their training, their insights, their work ethic. If this is true, why do so many do it so poorly? When we buy a copier, lease space, buy a car, etc. we do research, we ask around, we make comparisons. Many practices hire staff based on a quick interview, maybe a background check and hope!nnSo many people are so good at writing resume’s making even the smallest experience look amazing. We—as employers—cannot say anything bad about a former employee when asked by a potential employer. That leaves us to make what could be a huge and costly decision based on an interview. All the world is a stage and anyone can be good for the 30 min (at most) interview.nnStaff recruitment and Placement is one part science and one part art:nnThe Science: Being able to see all the different websites, monitoring careers, having market trust and a network which allows for honest and straightforward assessments from former employers, neighbors, and colleagues.nnThe Art: That intuition and experience that allows for placement: Finding the best person, personality, attitude and ethos for the position, job and the culture.nnWe do staffing and we do it very well!nn
nn
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.
Apr 21, 2017 | Uncategorized
Welter Healthcare Partners is excited to present our monthly Code Spotlight! Each month, Welter Healthcare Partners will spotlight a unique CPT or ICD-10 code to profile and discuss practice applications of the code, as well as pertinent guideline reminders. nn99291: Critical Care Services (99291-99292 – Critical care, evaluation, and management of the critically ill or critically injured patient; first 30-74 minutes) are some of the most heavily scrutinized codes in all of CPT! They are a huge target for all payers and have put many Critical Care/Pulmonology practices out of business or on the dreaded Pre-Pay system due to lack of compliance. Here are some of the essentials for compliantly billing for critical care services:n
n
- Documentation must support the patient meets the definition of a “critically ill or injured” patient. A critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life threatening deterioration in the patient’s condition. Be consistent regarding the critical risk of the patient throughout the entire note.
n
- Documentation must also support time spent rendering critical care (a minimum of 30 minutes of critical care must be provided).
n
Apr 21, 2017 | Uncategorized
CLICK TO ENLARGE IMAGE
nnTriCare is changing contractors! TriCare’s new carrier/contractor will be Health Net Federal Services. In the process of changing they are re-contracting and re-credentialing the provider network. Please be careful to fully read the new TriCare contract and make your on-going participation decision. If you need assistance, please do not hesitate to call us. We are always happy to help!nnAs the longest serving managed care support contractor for TRICARE, the Department of Defense’s (DoD) uniformed health care program, Health Net Federal Services, LLC (HNFS) is honored to provide health care services to active and retired military service members and their families.nnTRICARE is currently managed in three regions in the United States (North, South, West), with HNFS managing the TRICARE North Region since 2004. In 2017, these regions will condense to two – TRICARE East (merges the current North and South regions) and TRICARE West – under the next iteration of TRICARE known as T2017.nnIn July 2016, the DoD awarded the T2017 TRICARE West Region contract to HNFS, with health care delivery expected to start mid-2017. We welcome the opportunity to support our service members and their families in the TRICARE West Region and invite you to join our provider network as we carry on the vital mission of the TRICARE program. TRICARE covers a wide range of health care benefits you can help us deliver. Together, we can continue to provide health care excellence for our nation’s best.nnHealth Net Federal Services currently completes processing of clean claims for our TRICARE North Region providers in less than five days and offers online self-service tools to streamline your TRICARE transactions. Our TRICARE network providers agree to use Web-based tools to check beneficiary eligibility, validate whether a service requires prior authorization, submit prior authorization and referral requests, and submit claims electronically. In addition, network providers must agree to accept a discount off the TRICARE maximum allowable charge.nnPlease review the T2017 Frequently Asked Questions (FAQs) on the back side of this letter (see flier, right) and the enclosed Join Our Network form. To join the HNFS network, complete and return the form to request a T2017 Network Provider Agreement. Health Net Federal Services greatly values your commitment to the health and well-being of our active and retired service members and their families. Please contact us at HNFST2017ProvRel@Healthnet.com with questions not addressed in the FAQs.
Apr 14, 2017 | Uncategorized
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!
n nn
nn
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.
Apr 14, 2017 | Uncategorized
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
n
- Partial colectomy with end colostomy.
n
- Small bowel resection with primary anastomosis.
n
- Flexible sigmoidoscopy.
n
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
Click Here To View Full Case
Apr 14, 2017 | Uncategorized
CLICK TO ENLARGE FLIER
nnAs you know, the new era of healthcare and the Affordable Care Act (ACA) has brought monumental changes and challenges to physician reimbursement and operations—expanded insurance coverage, threats of decreased reimbursement, increased patient cost share, data collection, and payer audits to ensure proper provider coding and documentation are just a few!nnFor 20 years, Welter Healthcare Partners has helped physicians and practices increase revenue and thrive! We understand that proper revenue cycle management is the lifeline of your practice! After all, it’s a $2 Trillion industry. There is plenty of money; it’s just in different places than it used to be.nnDue to the unprecedented challenges you face, we will perform… a free revenue assessment and free follow up consultation.nnAllow us to quickly, professionally and confidentially assess your practices’ revenue cycle. There is absolutely no obligation! If we can help you we will let you know how, and why. If we can’t help, we will be straight–up and tell you. You have nothing to lose, and possibly a lot more reimbursement to gain!n
n
- Analysis of charges, payments, and write-offsn
n
- What we need: 12-month report (reported by month)
n
n
n
- Provider Coding Analysisn
n
- What we need: List of all CPT codes used and number of times reported (12-month report, by provider)
n
n
n
- Fee Schedule Analysisn
n
- What we need: List of all CPT codes and fees (what you charge)
n
n
n
- Insurance Contracts Analysisn
n
- What we need: List of major insurance contracts, rates, and when last negotiated
n
n
n
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.