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Legacy Accounts Receivable Wind-Down Services

Legacy Accounts Receivable Wind-Down Services

MiraMed Global Services (MMGS) has established protocols for working accounts to conclusion regardless of balance amount or payer. These protocols ensure consistent and thorough follow-up on all accounts referred. Our clients determine the scope of services required based on their internal resources and how they intend to focus those resources during the conversion period.

Download Legacy A/R Wind-Down Flyer

MiraMed then creates a customized legacy AR outsource program that will:

  • Liquidate legacy AR balances within the designated timeframe
  • Adhere to the client’s collection practices and policies
  • Assist in meeting revenue realization
  • Enable client staff to focus on technology training and transition issues
  • Provide a cost-effective solution versus in-house staffing for legacy AR resolution

Security and Technology Provide Reliability

We understand that connectivity and security are paramount when dealing with healthcare data. This, in combination with our proprietary AR Tracker software, provides security and accuracy. Our AR Tracker system has sophisticated inventory controls that ensure accounts are handled timely and efficiently. It allows us to maximize productivity by segmenting the inventory to ensure that focus is on the highest priority accounts. It also allows MMGS to provide value-added trending data and reports regarding the inventory that has been placed.

AR Tracker Benefits

There are many benefits to using AR Tracker to streamline our account representatives’ work flow, including:

  • Ability to load a large amount of data into the system and then categorize and prioritize it based on specific criteria 
  • Accounts can be sorted by payer which allows us to status multiple claims with one phone call
  • Accounts can be sorted by procedure, provider, etc. which allows us to view accounts that meet a specific criteria as trends are identified
  • Ability to create work queues for account representatives and monitor production on an hourly basis
  • Work queue re-allocation can be done at the supervisor level
  • Each account representative’s work queue only shows the accounts that are scheduled to be worked that day
  • Sophisticated inventory controls ensure recently re-billed or appealed claims aren’t touched too soon
  • Accounts paid in full are automatically removed from the representative’s queue
  • Standard reports can be generated using action codes to know the current status of an account
  • Reports can be customized for each client
  • Has a separate module for QC where accounts are randomly assigned to QC representatives for review
  • QC reports can be generated based on the QC representatives data input

Resolution of invoices will be defined as:

  • Payment
  • Payment and contractual adjustment
  • Write off of outstanding charges based on time barred, bundled charges, non-covered charges, nonauthorized procedures and/or charges denied as non-supported by medical records
  • Identification of charges as due from patient as deductible, patient portion or non-covered by third party payer MiraMed has the size and experience to handle large volume projects while at the same time offering a costeffective solution to our clients.

Trauma Registry

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Trauma registry

MiraMed provides support for Trauma Centers designated by the American College of Surgeons (ACoS), who are qualified as definitive care centers for adult as well as pediatric patients. Our trauma registrars are required to maintain a designation of Certified Specialist in Trauma Registry (CSTR) and Certified Abbreviated Injury Scaling Specialist (CAISS) a trauma scoring system vital to trauma research, as recognition of their knowledge of basic trauma registry.A CSTR is a valuable asset to the functionality of an efficient trauma program; their contribution to abstract trauma injuries at a designated trauma center contributes to the information used nationwide to improve overall patient safety and care. This data is collected by the Centers for Disease Control and Prevention (CDC) for performance improvement and patient safety monitoring.

Download Trauma Registry Flyer

Our Team

MiraMed employs Trauma Registrars with the dedication and commitment to work remotely or onsite. Our consultants exhibit professionalism, experience and the ability to abstract cases with a full understanding of inclusion and exclusion criteria in accordance with the standards of National Trauma Data Bank (NTDB). A knowledgeable and credentialed CSTR will have experience with one or more of the four recognized trauma registry software programs to capture and validate essential injury criteria.These professionals have been screened and their certifications, work experience, education and training have been validated. Our competitive salaries and benefits provide an environment that fosters a secure workplace with solid staffing, ready to contribute to your program and its success.Call Today! (877) 641-9913 or email us . 

Oncology

Oncology Data Management

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Why MiraMed Oncology Data Management Services?

MiraMed understands the needs of our clients to have credentialed and experienced registry professionals available. Our support includes operational assessments, elimination of backlogs or assistance in preparation of pristine survey; operating within the standards of the American College of Surgeons, Commission on Cancer (ACo, CoC). MiraMed has built a solid reputation on superior customer service and client satisfaction. We believe that superior customer service begins with the right people and that client satisfaction is maintained with highly trained professional account managers and recruiters who have experience within the health care industry. MiraMed is able to provide onsite and remote Certified Tumor Registrars™ (CTRs) to abstract accurate and timely data collection for our clients. Our team members are committed in keeping current with their continuing education regimen in the areas of:

  • Collaborative Staging
  • Surveillance Epidemiology and End Results (SEER)
  • National Accreditation Program for Breast Centers (NAPBC)

Our consultants provide leverage to our clients’ programs by keeping up-to-date with the latest information from the CoC, NCRA, NAACCR and State/Local registries.

Download Oncology Data Management Flyer

Guaranteed Quality with Integrity

Remote abstracting is a convenient and cost effective solution to meet each one of our client’s cancer registry demands. While our client’s core team continues to manage their day-to-day operations, our remote abstractors will supplement current staff by assisting in:

  • Reduction of backlogs
  • Working on special projects
  • Supporting clinical research platforms
  • Filling temporary vacancies
  • Providing vacation coverage
  • Assisting in annual survey preparation

We provide a tailored solution for each client’s organizational needs. Our staff is tested and monitored to ensure that productivity and national workload standards of quality are achieved; these include:

  • Client and consultant review within the first two weeks of project launch
  • Continual progress reporting of abstracted cases
  • Quarterly audits for long term contracts

MiraMed provides data management systems webinars (DMSW) as part of our ongoing effort to provide our CTRs with the most current oncology data management systems information. MiraMed is a focused health information management service. We are committed to building a quality partnership in support of the abstracted data for cancer prevention and clinical outcomes. Call Today! (877) 641-9913 or This email address is being protected from spambots. You need JavaScript enabled to view it..

HCC Coding

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HCC Coding Hierarchical Condition Categories, referred to as HCC, is a method of maximizing services to patients while receiving additional revenue to cover such services. HCC incorporates clinical documentation, coding, auditing and reimbursement. Leaving a diagnosis under documented, not substantiated or not coded could result in loss of thousands of dollars per patient. When implemented correctly, the benefits impact the patient, the organization and the healthcare community.

Payers reimburse hospitals and providers a flat-fee per patient, known as capitation. With HCC, in addition to the flat fee, for management of designated chronic diseases, payers increase reimbursement for the care and treatment of such diseases. This is referred to as “volume-to-value” and by 2020 will be the way in which 80% of contracts across all payers are designed. It is still referred to as a “risk-based agreement” because the provide shoulders rendering services, properly documenting and coding to achieve an increased fee to cover the additional services patients require to improve conditions such as laboratory, screenings and additional office visits, all ultimately resulting in less medications and hospitalizations.

  • HCC reimbursement rates are increasing over the next three years
  • There is a financial benefit to providers and payers for correctly capturing all HCC codes
  • There are approximately 11,000 codes that map to HCCs that need to be understood and captured

HCC Coding:

  • Reviews HCC medical records and coding both concurrently & retrospectively 
  • Evaluation of HCC Program with Findings and Recommendations
  • Training of Providers, typically web-based
  • Post provider training, re-audit/evaluate sample of HCC records

 

 

MMGS provides the following additional steps to ensure the most complete HCC Coding and the greatest opportunity for reimbursement for clients:

  • Discovery
    • Information Gathering to maximize Findings e.g. Preliminary RFA17 EAPG Weights
    • Perform a scoping e.g. Community Health Center, Accountable Care Organization, Hospital ACO, etc.
      • Count(s)
      • Weight(s)
      • Reimbursement
      • ICD-10 CM diagnosis codes with EAPG Assignment
      • HCPCS codes with EAPG Assignment
      • New and deleted HCPC codes
      • SME recommendations on sample size to establish a baseline for organization.
  • Evaluate and validate existing population
  • Review potential shifts in chronic conditions
  • Validate coding compliance, both technical and process
  • Summary of Findings
    • Scorecard (Baseline & Range, Averages, Target Areas, etc.)
    • Opportunities
      • Program
      • Documentation
      • Coding
      • Auditing
      • Technology Review
    • Population Health
      • Over/under utilization of patient care services
      • Over/under staffing of clinical staff to serve patient base 
      • Ancillary services to maximize patient care
      • Medication Management
      • Shortfalls of coordination of care for overlapping chronic conditions 
      • Over/under utilization of laboratory services
      • Over/under utilization of screenings e.g. colon, cardiac, etc.

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