MONTHLY AUDITING PROGRAM
ACE, knows that you hold essential the values for an active compliance program and understand compliance is a long-term ongoing commitment. The OIG model compliance plan indicates that to ensure a compliance program is being followed a group should conduct periodic audits.
Do you have trouble getting around to getting the monthly auditing done? Let ACE be your monthly auditing agent.
ACE can again assist your practice in remaining compliant. As you know, our staff has the expertise to assist in all phases affected by compliance guidelines.
We have put together a list of items that we believe every practice should be checking on throughout the year in order to demonstrate active compliance. In the past we have given the lists for you to do. We know how busy you are so, now we are offering to do them for you.
We propose that monthly audits are focused on specific items as follows:
January – Anesthesia time review
February – Post-operative pain, including daily management
March – Line documentation review
April – Medical direction elements review
May – Monitored Anesthesia Care, medical necessity
June – Concurrency, relief services
July – Coding; ICD-9-CM and CPT/ASA coding verification; modifiers
August – OB anesthesia
September – Reimbursement
October – Pre-operative evaluation, physical status
November – Contract verification for one insurance
December – Monitoring AR guidelines against National Benchmarks
The program would work like this. We agree on a twelve month schedule. The group will be sent an E-mail on the 20th day of the Month requesting the information. This information will be due in our office by the 5th work day of the following month. Chart reviews will be limited to 25 charts. We will perform the task, document it for your compliance plan and if findings are significant, we will have a telephone consultation with you as to the proper corrective action steps that should be taken. This will help to keep your plan active and your finger on the pulse of compliance for your practice.
The fee is $500 per month payable by the 15th of the following month. We are limiting this to ten practices so if you are interested, please call.
REIMBURSEMENT REVIEWS
Outsourcing your billing function requires a special oversight responsibility from physicians. Not only do you want to be sure that they are submitting your claims correctly, it is also important to insure that you are getting paid properly for the services that you perform.
In recent reimbursement audits, we have found numerous errors resulting in physicians not being compensated correctly. These audits focus on reviewing accounts receivable reports, contracts, explanations of benefits and denials received from the claims files.
Holding billing companies accountable is an important element in your compliance activities.
EDUCATION
Now you don’t have to send your staff across the country for the best conference on pain management and compliance training. ACE will bring their extensive knowledge to you office!
This workshop is a comprehensive combination of:
Instruction on Documentation – solid advice for the physicians for completing medical records that meet government requirements
Education – designed for physicians, CRNA’s and office staff to promote awareness of billing regulations and compliance throughout your organizations
Assessment/Evaluation – an exam is administered at the end of the course to be sure the participants understand the materials covered. You’ll uncover any weaknesses in your staff so that retraining can be addressed.
BUSINESS PLANNING & OPERATIONAL AUDITS
Sometimes an outsider can help you see the bigger picture. ACE consultants are available to visit your practice and conduct a basic assessment in all areas. We can offer beneficial feedback and suggestions for improvement.
INTERIM MANAGEMENT
There are times when you need someone just to step in for a while. ACE, Inc. has the knowledge and expertise to keep your practice running smoothly without missing a beat. Call to discuss the variety of options.
PRACTICE OVERSIGHT
Initial On-Site Operations Review - $2500.00
Evaluate current operations, including patient flow, information flow, space and floor plan, medical record, computer system.
Establish statistics to monitor daily, weekly, monthly, quarterly, annually.
Review staff task assignments, staffing levels, job descriptions, staff training.
Assist in developing short and long-term goals. Assist in plan to reach goals.
Review marketing plan. Assist with marketing strategies.
On-Going Practice Oversight - $500.00 per month
Five hours of phone contact, additional hours available at $150.00 per hour.
On-going monitoring of billing activity.
Monthly phone conference.
Review insurance carrier contracts. Monitor allowables by carrier. Assist with contract negotiation strategies.
Updates regardding CPT and ICD9 coding.
Research answers to questions
PRACTICE MANAGEMENT
If you’re thinking about starting a new practice, ACE will walk you through the entire process, from finding the right location, making sure the floor plan is efficient down to your grand opening.
An ACE auditor will answer all your questions and meet any challenge. We cover revenue and expense projections, staffing ratio and expense, capital expenditure, business and marketing plans, finance options, insurance contracts, employee benefit options, procedure manuals, job descriptions, employee manual, OSHA, CLIA, compliance HIPAA, computer software and hardware options.
Planning, understanding, and training will allow patient care to be the most important issue for physicians and staff when the clinic opens.
