HSMN recently announced a new Physician Practice Management Reimbursement Readiness Program in which it would provide Physician Groups with an internal capability to demonstrate outcomes of their practice of Medicine.
Wellington, FL -- (SBWIRE) -- 02/15/2013 -- HSMN recently announced a new Physician Practice Management Reimbursement Readiness Program or PPMRRP in which it would provide Physician Groups with an internal capability to demonstrate outcomes of their practice of Medicine. It is important that Medical Practices begin a transition that allows them to track outcomes. The first order of business is to review cases done by all of the partners or associates in the Practice and establish a standard for every procedure and diagnoses.
Many of these standards are intuitive in that Clinicians almost always know where there should be based on diagnosis, treatment plan and therapeutics. The Standards for the “Practice” need to be quantified against national standards in Evidence based medicine. A good start is within the practice.
So HSMN reviews cases based on algorithms it has developed over the years, the basis for which reside in CMS databases.
A spokesman for the company said, “We study the clinical documentation, review the reimbursement or denial and we begin the process of how the practice will do under the new reimbursement scenarios including ICD-10-CD coding.” This analysis is critical in the denial management process.
HSMN’s system is totally dependent upon the individual practices. It allows each practice to say that based upon our demographic, patient age, diagnoses etc., here are our outcomes. Over the last several years there have been enormous strides in the maintenance of post hospitalization of heart patients who are given certain meds to take including the baby aspirin.
HSMN’s job is to codify and quantify the standards within the practice to be able to demonstrate to any payor the quality of its outcomes. HSMN is convinced that all payors will begin using such standards but still pay for volume of procedures and visits as long as outcomes appear to be reasonable.
While the next stage of paying for quality may be off in the future, it is important for each physician practice to begin the process of understanding the quality of the outcomes in the practice reflected in the clinical documentation so that they can be demonstrated to third party payors.
About HSMN
HSMN has worked with Physician Practices for 27 years on improving reimbursement. Please contact HSMN 1-866-908-4226 or info@hsmn.com for a consultation.