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!
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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.
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
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- Partial colectomy with end colostomy.
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- Small bowel resection with primary anastomosis.
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- 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
Click Here To View Full Case
Apr 14, 2017 | Uncategorized
CLICK TO ENLARGE FLIER
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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.
Apr 5, 2017 | Uncategorized
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.
Apr 5, 2017 | Uncategorized
Week 1 – Industry Hot Buttons!nnMACRA: As a result of Congress repealing the historic SGR (Sustainable Growth Rate) reimbursement formula last year, a new pay–for–performance model has been introduced that will directly impact Part B reimbursement. Physician practices across the country will either be incentivized or penalized via reimbursement based on performance and quality care outcomes. The new model, specific to Part B providers, called MIPS (Merit–Based Incentive Payment System) will consolidate all other CMS alternative merit-based incentive programs (PQRS, VBM, EHR incentives) and provide bonus payments to participating providers of eligible APMs (alternative payment models). MIPS helps link fee-for- service payments to quality and value. This epic change became effective on January 1, 2017, so it imperative that your practice is ready to comply with these new requirements.nnModifier 25: Modifier 25 landed itself on both private payer and the OIG hit lists again this year for overuse and blatant misuse leading to millions in overpayments – and everyone wants their money back! Applying Modifier 25 incorrectly can cost your practice tens of thousands of dollars! Understanding this modifier’s appropriate application can be very tricky.nnHere are a few questions to consider before sticking that modifier on your next claim:n
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- Was the patient scheduled to come in for a planned study or procedure only? Did any notable events occur that would affect the service beyond the study or procedure?
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- Was the evaluation and management service provided significant and separately identifiable to the procedure or diagnostic study provided at the same encounter?
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- Is active management of a significant and separately identifiable illness/ailment with preventive services for additional problems identifiable in the provider’s documentation?
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CLICK HERE TO SUBMIT A CASE STUDY TO THE SURGERY CODING SERIES, DEBUTING NEXT WEEK!
Apr 5, 2017 | Uncategorized
Welter Healthcare Partners is pleased to announce that our brand new website is launched and LIVE!! nnThat’s right, you can head over to WHPelter.com right now to explore our new, and polished website! This is a massive step forward for Welter Healthcare Partners. A huge amount of work has been put into this launch, and we are thrilled to share the results.nnMoving to this new website means we now have easier navigation and access to new features, plugins, a new format for coding information, and everything in between. We have published a plethora of resources outlining our capabilities and services relating to credentialing, recruiting, interim management, and medical billing and coding.nnWe offer personalized accounting services designed to help you identify opportunities for increased profitability and growth. Our recruitment team is ready to find the perfect, qualified personnel at a lower cost. Welter Healthcare Partners practice management consultants can immediately step in to maintain day to day operations, provide experienced leadership and keep the current processes and systems in place during the transitional period. Our complete coding services can help you navigate through the complicated coding maze to maximize your revenue and stay current with the constantly changing coding rules and guidelines.nnFor your convenience, you will find a revamped newsletter featuring:nnWeek 1 – Industry Hot Buttons!n
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- Welter Healthcare Partners is excited to provide insight and guidance on complex and obscure topics in healthcare. Including the OIG work plan, Modifier 25, Incident To, HCC, etc.
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nWeek 2 – Surgery Coding Series!n
nWeek 3 – Code Spotlight!n
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- Welter Healthcare Partners will pick a unique CPT or ICD-10 code to profile for that week and discuss practice applications of the code as well as pertinent guideline reminders.
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nWeek 4 – Professional Development Tidbit!n
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- Welter Healthcare Partners will share helpful career advancing tips and strategies to sharpen the skills prospective employers look for in a coder!
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AMRSCO.com Is Officially Live!
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On top of this, we also launched the new AMRS website! AMRS is a team of advanced medical billing specialists offering comprehensive revenue cycle management services. They pride themselves in accurate and effective coding, billing, and collecting in order to boost company profitability. Boasting over 50 years of coding and billing experience, AMRS already knows how to bill and—above all—fight for due payments in a timely fashion! AMRS’ medical billing services increase current revenue by 10% or more, with our team of experts working hard to increase cash flow and prevent volatile ups and downs.
