Provider Services

Annual Support Services

Our annual support and retainer services include the following:

Telephone and email support for your coding and compliance questions
Complimentary access to any on demand webinar
Annual risk assessment
Annual review of up to 20 charts
Annual bell curve and code utilization

Auditing & Monitoring

Our goal is to evaluate coding accuracy to ensure you are in compliance with industry guidelines, rules, and regulations.

Services include:

Prospective coding audits
Retrospective coding audits
Concurrent coding audits
Focused coding audits
Clinical documentation improvement/coding impact audits

Claims Denial Support

To mitigate the financial damage of denied claims, the best defense is to prevent them from happening in the first place. The key is understanding the most common reasons claims get denied:

Prior authorizations
Missing or incorrect information
Medical necessity requirements
Procedure not covered by payer
Provider out of network
Duplicate claim
Coordination of benefits
Bundling
Services already included in payment of another service or procedure
Exceeded timely filing limit

Clinical Documentation Improvement

Today's healthcare organizations recognize that proper clinical documentation is critical to their operations. Successful organizations accurately reflect the care that was provided and the status of each patient, which in turn streamlines and maximizes reimbursement. A great Clinical Documentation Improvement (CDI) Consultant can help you navigate and elevate your documentation practices to the next level.

We offer two different CDI options:

Full - Service CDI
CDI Audits

Compliance Program

Kennedy Neghan Healthcare Resources can provide the following services:

Develop and implement your Code of Conduct and Compliance Plan
Conduct compliance education and training
Provide compliance support for your staff

Consulting & Guidance

Personalized consultations are an excellent way to determine the extent of your needs and the exact information your office requires to meet these needs.

Corporate Integrity Agreement Support

If your organization is in the process of negotiating, implementing, or managing a Corporate Integrity Agreement (CIA), Strategic Management can provide expertise to help you comply with CIA obligations. We have extensive experience with CIA compliance with federal healthcare regulations and can help organizations across the healthcare industry meet important CIA deadlines and requirements.

Due Dilligence

Evaluating potential or actual compliance risks is necessary for any healthcare organization during a merger and acquisition. Strategic Management’s due diligence reviews assist healthcare organizations and purchasers to identify compliance risks that must be properly accounted for in any merger and acquition transaction.

Education & Training

Kennedy Neghan Healthcare Resources, LLC, offers many forms of billing, coding , and compliance education to include the latest regulations and updates for many payers and specialties.

We offer education and training opportunities to fit your need and schedule by providing live webinars, on demand webinar, or onsite education and training.

Our topics include:

Incident-to
Modifier - 25
Evaluation and Management Guidelines

Policies & Procedures

Formalized, written policies and procedures fulfill a number of important purposes:

Facilitate adherence with recognized professional practices.
Promote compliance with regulations, statutes, and accreditation requirements
Reduce practice variation
Standardizes practices across multuple entities, within a single health system
Serves as a resource for staff
Reduces reliance on memory

Revenue Cycle Management

The success of your practice is determined by effective management of your revenue cycle. We provide a comprehensive assessment of your current billing processes to determine where your practice may have opportunities to capture missing revenue.

Our team can help you:

Reduce lost revenue
Maximize reimbursement opportunities
Reduce denials and appeals
Achieve successful reimbursement
submit clean claims

Risk Assessments

A risk assessment is a systemic process for identifying, evaluating, and prioritizing potential events that could negatively impact the organization and why you should have one:

Increased focus on compliance issues by regulators
Recent high profile enforcement actions
Ability to use results as a tool to drive strategic changes
Insight into key issues/risks facing the business
Greater transparency, sustainability, and corporate governance
Pressure from stakeholders (customers)