Solutions Across Continuum of Care
Solutions for providers, payers, device, genetics and precision medicine, pharmaceuticals, health IT, investors, and legal teams.
Expert solutions
Expert solutions, including medical billing expert, medical billing expert reports, and medical billing expert rebuttal reports; certified electronic health record technology expertise
Solutions across the continuum of care for providers, payers, device, genetics and precision medicine, pharmaceuticals, health IT, investors, and legal teams
Expert witness litigation consulting and solutions for health care providers including physicians, groups, diagnostic imaging, independent diagnostic testing facilities, lab and pathology, genetics and precision medicine, pharmaceutical, medical device, payers, Health IT, clearinghouses, healthcare investors and health law / litigation consultingSolution |
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| Ambulance coding and billing risk management reviews |
| Accountable Care Organization, quality measures strategies |
| X12 EDI HIPAA claim data transaction parser for interactive restrospective forensic reason code reviews; HIPAA real-time parser for fraud propsective / premtive fraud detection |
| Best practice implementation tracking tools |
| Business process, integration, master data management solutions |
| Capabilities to reduce the cost of healthcare, accelerate reimbursement |
| Claims disbursement process improvement solutions |
| Claims submitter, provider coordination for improved adjudication |
| Clinical documentation improvement for medical specialties, for ICD-10 & EMRs (CDI) |
| Clinical documentation improvement retrospective review of MS-DRG affected chargs and supporting clinical documentation |
| Clinical documentation improvement constant analysis for coding gaps and accuracy, additional clinical documentation not otherwise coded, and opportunities for targeted physician education |
| Clinical documentation improvement: Provide initial and ongoing peer-to-peer physician education sessions addressing MS-DRG documentation requirements, definitions, criteria and importance of clear and consistent clinical documentation |
| Clinical documentation review state: Concurrent review - performed while the patient is in the hospital, before discharge. Retrospective - pre-bill review - performed after discharge at the time of coding. Retrospective - post-bill review - performed after discharge and after the claim as been billed. |
| Clinical template development and specialty coder training |
| Clinical vocabularies, medical concepts for transitioning to ICD-10 |
| Community health needs assessment |
| Data conversion surety, security and integrity, validation, quality |
| Data quality and integrity |
| Diagnosis and procedure coding quality and compliance (see CDI) |
| Electronic Health Record, HIPAA Privacy Rule, HIPAA Security Rule, and ARRA HITECH Act Meaningful Use Information Safeguards Privacy & Security Risk Assessments |
| Electronic health record (EHR) Integration via HL7, Fast Healthcare Interoperability Resources (FHIR, pronounced "fire") and Service Oriented Architecture standards |
| Electronic health record (EHR) vendor contract review for providers |
| Electronic health record (EHR), practice management solution selection & implementation |
| Enrollment, eligibility-employer, Medicaid (MAGI, CHIP, TANF) |
| Executive education, physician and coder training, specialty training |
| Forensic audit of electronic health records |
| Gap analysis, vendor readiness dashboards for ICD-10 |
| HCC severity & risk adjustment impact in diagnosis coding |
| Health care social media, patient outreach & education |
| Health IT investment due diligence |
| Home Health Resource Group (HHRG) analytics |
| Home Health Patient-Driven Groupings Model (PDGM) analytics See https://noworldborders.com/2019/12/29/home-health-patient-driven-groupings/ |
| Healthcare company, HIT vendor risk assessment and due diligence |
| ICD-10 Project Kick off, governance, project plan |
| ICD-10 readiness, roadmap, strategy, and implementation |
| Incentives keep Accountable Care Organization members in network |
| IT Portfolio and Labor Spend Management Dashboards |
| Litigation support / expert witness, appeals |
| Maximize meaningful use of EMR incentive payments |
| Meaningful use Critical Findings Notification Workflow audits |
| Medical policy management & benefit design |
| Medicare Advantage 5-Star HEDIS process improvement, reporting |
| CMS Hospital Value Based Purchasing |
| Process discovery, complex business events |
| Process improvement, tools for repeatable HIT implementations |
| Provider / physician advocacy for HIT projects |
| Revenue cycle / accounts receivable audit, analytics |
| Specialty diagnosis and procedure coding & clinical documentation |
| HIPAA Privacy and HIPAA Security Compliance Advisory |
| ICD-10 business roadmap |
| ICD-10 training |
| ICD-10 high-level review |
| ICD-10 In-depth assessment |
| ICD-10 gap analysis |
| ICD-10 vendor readiness |
| ICD-10 implementation plan |
| ICD-10 test plan review |
| ICD-10 financial and risk modeling |
| ICD-9 to ICD-10 documentation |
| ICD-10 Governance, steering committee composition |
| ICD-10 Training and specialty Training - Physician |
| ICD-10 Training and specialty Training - Coders |
| ICD-10 Coding and data quality |
| Impact training for managers and executives |
| ICD-10 Skills Assessment |
| ICD-10 Interim leadership |
| ICD-10 assessments |
| ICD-10 business roadmap & strategy |
| ICD-10 organization change mediation |
| ICD-10 physician engagement |
| ICD-10 gap analysis |
| ICD-10 HIT vendor assessments |
| ICD-10 vendor and provider readiness dashboards |
| ICD-10 DRG data analytics overview |
| ICD-10 virtual implementations and testing |
| ICD-10 Implementation planning |
| ICD-10 clinical documentation (inpatient, outpatient) |
| ICD-10 application modernization |
| ICD-10 business rules |
| ICD-10 medical concepts |
| ICD-9 to ICD-10 crosswalk tools |
| ICD-9 to ICD-10 tool assessments |
| ICD-10 enterprise integration |
| ICD-10 testing |
| ICD-10 revenue cycle analytics |
| ICD-10 impacts on payer claims auto adjudication |
| ICD-10 data, coding quality & governance |
| ICD-10 and AHRQ patient safety indicators |
| ICD-10 impact on Accountable Care Organizations |
| ICD-10 and Medicare Advantage and Part D |
| ICD-10 impact on quality & safety measures |
| ICD-10 HIM and IHI process improvement |
| ICD-10 Master Data Management, process data |
| ICD-10 business events, instrumenting the enterprise |
| ICD-10 business process discovery, management |
| Meaningful Use Audit Defense |
| Pathology billing and coding expert witness |
| MIPS, MACRA strategies and best practices |
| Drug pricing expert witness |
| Usual customary and reasonable cost of care expert witness |
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