CDM and Order Menu Review
Whether you need a comprehensive review, a focused single department review, ongoing maintenance, or a consolidation of multiple CDMs, our projects are tailored for you.
Charge Capture, Compliance, Medical Necessity Admission and RAC Reviews
Hospital payments are increasingly coming under close scrutiny by CMS, OIG, OMIG and other payers, not to mention the RACs (Recovery Audit Contractors). It makes good business sense to know your areas of risk and address them before the payers do it for you. With our compliance consulting services we will work with you to screen your billing data, manage your denials, identify risk areas, and develop strategies to assess and correct these issues.
Commercial Payer Contract Support
Hospitals need to approach contract review and negotiations fully apprised of term implications and financial impact. Establishing an appropriate managed care strategy and entering into negotiations with accurate financial models is critical to ensure that your Hospital can negotiate favorable contract terms. Epoch understands the intricacies of contract modeling and has the experience in analytics to provide the Hospital with reliable contract models as well as contract payment integrity
Epoch offers a full complement of ICD-10 services to insure that your Hospital or Physician Practice is prepared for the implementation of ICD-10. In order to maintain a consistent revenue stream, providers must anticipate and prepare for all areas affected by ICD-10. Epoch can assist you with implementation assessments and strategies.
Inpatient and Outpatient Coding Reviews
Epoch will review your medical record documentation and coding in accordance with coding and regulatory rules and guidelines and provide documentation to support suggested changes as appropriate. When requested, our consultants will work with you to get to the root cause of identified coding issues (e.g., documentation, education) and help to address the problem. You design the approach that works best for you.
Professional and Split Billing
The current health care trend is for hospitals to take on professional practices or hire specialty hospitalists—in effect creating one-stop health care. Hospitals must now bill for professional as well as technical services. Medicare and some state Medicaid programs pay additionally for physician and some mid-level professional billing. You need to know exactly where and when you can bill these services.
Regulatory Support and Guidance
Need answers to regulatory questions? Not sure how to bill for a specific service? Establishing a new service? Let Epoch provide regulatory research and guidance support. The answer to many staffing and billing questions is not clearly laid out in the regulations and must be gleaned from multiple resources and regulatory documentation. We have the clinical, coding and billing expertise across a full range of services. These engagements may be set up to address a specific issue or on an ongoing, as needed basis. We are here to meet your business needs.
Revenue Cycle Review and Assessment
Epoch is equipped to assist you in addressing focused and general operational revenue cycle reviews and assessments.
Specialized Educational Services
Epoch can support you by designing a single session or a complete education program to meet your education needs. Epoch Partners are frequent speakers at both national and local level programs for HFMA, Health Information Management, and Patient Accounting groups.
Strategic Pricing, Peer Pricing and Transparency in Pricing Studies
Epoch can provide a strategic pricing strategy that incorporates a clear and rational approach to price setting and markups. The strategy takes into account a variety of factors including hospital objectives, payer contracts, and general public relations.