Revenue Cycle Assessments
AAFCPAs performs internal control reviews of the revenue cycle operation to help clients capture more revenue. This involves assessing the controls and procedures from the front end through the back, and all the various layers in between in the collection of accounts receivable. We perform analysis of your insurance verification process, authorization & re-authorization process, timing of billing, and collection follow-up. We take an objective and subjective look at your people, process, and technology and make pragmatic and best practice recommendations in areas where FQHCs may increase reimbursement and improve revenue cycle management efficiency.
Fee Structure Analysis
We review current medical, behavioral health, and dental fee structures to determine adequacy of rates charged and make rate setting recommendations to ensure optimal reimbursement.
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Matthew Hutt
Courtney McFarland
Charles Webb
Sliding Fee Discount Program Assessments
AAFCPAs assist clients in calculating medical rates and optimizing collection based on the HRSA’s Sliding Fee Discount and Related Billing and Collection Program Requirements. We ensure clients maintain organizational compliance, which includes documentation of policies and procedures to meet HRSA’s program requirements. We help clients avoid issues associated with an HRSA Operational Site Visit.
Medicaid and Medicare Cost Reporting
AAFCPAs has extensive cost reporting and reimbursement experience with both cost-based and Prospective Payment System (PPS) providers. We understand the importance cost reports hold for FQHCs. We provide guidance to ensure accurate completion, insight into the key objectives of the report, and critical areas of scrutiny of your disclosures. We frequently present training sessions to FQHC associations on best practices for minimizing the effort necessary to prepare, while maximizing reporting to properly reflect your true cost of care and maximize reimbursements.
Denials Prevention and Management
Most denials are caused by inefficient processes and can be prevented. Denials can be caused by internal issues, technology issues, or billing complications from third party payors. Interpreting the billing and coding requirements of a variety of payors can be challenging. AAFCPAs identifies opportunities to minimize denials and increase reimbursement. This includes identifying the causes for the denials and common themes. If the denials are caused by internal factors, we can provide training to prevent the denials from reoccurring. If the denials are caused by external payor issues, we work with clients to develop an action plan to address these with the insurance companies. We utilize our Data Analytics team as well as advanced, data mining software as appropriate to enhance our abilities to evaluate vast amounts of data found within complex, disparate information systems.
Dashboarding & KPIs
AAFCPAs helps FQHCs monitor the health of their revenue cycle with data analysis and visualization. This includes guidance on the appropriate metrics, or key performance indicators (KPIs), that inform your decision making. Our in-house data analysts work with your team to extract, inspect, cleanse, and model data in order to monitor real time the health of your revenue cycle operations.
Healthcare Consolidation & Coordination of Care
AAFCPAs has witnessed dramatic changes in the healthcare industry, including the current consolidation landscape and integration of behavioral health into the primary care delivery system. Our specialists are well-prepared to advise clients on forging innovative partnerships or consolidations that will improve the quality of care and clinical outcomes while controlling costs. We help clients to perform well-executed integrations that optimize both outcomes and profitability. This includes:
Vetting potential healthcare partnering arrangements, including comparative analysis of competition, cost structures & payment methods, practice patterns, quality of care, and clinical outcomes.
Guidance on changes in reimbursement and regulatory frameworks and the increased proliferation of high-deductible health insurance plans.
Analysis of Accounts Receivable & Third-Party Reimbursement.
Optimizing ROI on technological investments and aligning business process controls with performance objectives.
Guidance on improving processes and leveraging systems to streamline reporting and compliance requirements.
Development of tracking and monitoring systems for risk-based contracts. This involves determining the costs for providing the services to be covered under the contract. In addition, we also help to develop a system to monitor the services being provided and costs involved. The profit/loss on these contracts needs to be determined as well as how much is attributable to the organization. We consult on the level of reserves that are necessary for these contracts, and the accounting and financial reporting requirements.
Contact AAFCPAs
We look forward to speaking with you to determine how we may best solve your needs. A firm representative will reach out to your within one business day. Looking for additional ways to reach us? Visit our Contact Page. >>