Consulting Services

CONSULTING SERVICES

Experience, confidentiality, the right team plus proven software

Since 1983 we have been helping physicians to operate practices as a business, over 500 Medicare and Medicaid audits have given us the knowledge to develop the AccuChecker Product Line including Claims Scrubbers and for the 10 years we have been involved in HMOs Risk Management and have developed the MCAR Reports – Managed Care Reports.

HEDIS

HEDIS stands for Healthcare Effectiveness Data and Information Set which is a widely used set of performance measures in the managed care industry. HEDIS was developed and maintained by the National Committee for Quality Assurance (NCQA).

HEDIS reporting is mandated by NCQA and the Centers for Medicare & Medicaid Services (CMS) for accreditation and regulatory compliance. It is important that health care providers and staff become familiar with HEDIS to understand what health plans are required to report in order to improve the quality of patient care.

Quality Programs

The Quality Payment Program makes Medicare better by helping you focus on care quality and the one thing that matters most – making patients healthier. The Quality Payment Program ends the Sustainable Growth Rate formula and gives you new tools, models, and resources to help you give your patients the best possible care. You can choose how you want to take part based on your practice size, specialty, location, or patient population.

The Quality Payment Program has 2 tracks you can choose from:

·         The Merit-based Incentive Payment System (MIPS)

·         Advanced Alternative Payment Models (APMs)

Closing or Selling Your Practice

Are you thinking about closing or selling your medical practice? Several things must be considered when making such a career-changing decision. There are rules and requirements from the States Medical Board and guidance from the Texas Medical Association. If you will be retiring, you also may wish to talk with HPP Management Group, Corp., to discuss options for retiring physicians.

KEY:  Complaince is mandated avoid Penalties

Additional Services:

·         Risk Management

·         Medicare and/or Medicaid Audits

·         Billing and Coding

·         Practice Management

·         Provider Credentialing

·         Provider Contracting

·         Risk Management

·         Provider Registration

o   CMS ( Medicare and/or Medicaid

o   Health Plans

o   CAQH

For more details call HPP Management Group, Corp.

Paul G. Silverio-Benet

psilben@hppcorp.com    or  psilben@gmail.com

305-227-2383   or  305-975-1171

Understanding E/M Coding

HPP Management Group, Corp

Health Care Consultants – Our Services

Understanding E/M Coding

The HPI is made up of eight (8) elements:

·         Location

·         Duration      

·         Timing

·         Associated Signs/Symptoms

·         Context

·         Severity

·         Quality

·         Modifying Factors

The subcomponents of history include:

Ø  Chief Complaint (CC)

Ø  History of Present Illness (HPI)

Ø  Review of Systems (ROS)

Ø  Past Medical, Family, & Social History (PFSH)

There are many rules and guidelines a coder and a physician must be aware of when it comes to appropriately selecting an Evaluation and Management (EM) code and avoiding doubling dipping is one of them.  Double dipping occurs when the same information is used in more than one of the subcomponents of history.

                                                                                           Our Services

·         Billing and Coding

·         HEDIS Guidelines

·         Quality Measures ( Policy & Guidelines )

·         Provider Credentialing

·         Audits ( Medicare & Medicaid )

·         Review of Medical Records

·         Provider Assistance ( Deceased Physician, Relocation or Closing of Practice)

·         Understanding Risk Management

·         Provider Contracting

HPP Management Group, Corp. the titled-holder of Health Plans Path, Corp (HPP) and also the developers of the AccuChecker Product Line is a group of healthcare consultants servicing physicians and payers since 1983.

For More Details:

Paul G. Silverio-Benet

psilben@hppcorp.com  or  psilben@gmail.com

Call Direct: 305-975-1171  

Need A Healthcare Consultant

HPP Management Group, Corp

Health Care Consultants – Our Services

HPP Management Group, Corp. the titled-holder of Health Plans Path, Corp (HPP) and also the developers of the AccuChecker Product Line is a group of healthcare consultants servicing physicians and payers since 1983.

The HPP consultants have contributed to healthcare providers in many ways:

The Management Group has represented physicians in over 500 Medicare and Medicaid audits of overpayment assessments and has recovered millions of dollars for our clients. The knowledge acquired in the audits served as the basis to develop the AccuChecker Product Line.

·         Our team has conducted practice evaluations resulting in the implementation of successful solutions and businesses expansions as well as creating plans of corrections whenever needed.

·         Our consultants have presented coding and reimbursement seminars to physicians practices across the nation and have conducted workshop on claims adjudications and claims scrubbing techniques to payers, TPAs, MSO and IPA organizations.

·         The Health Plans Path, Corp. (HPP) division has been involved for the last ten (10) years in managing Medicare and Medicaid HMO Risk Management Operations.

·         During the last twenty (20) years the HPP team has been developing the AccuChecker Product Line – coding and reimbursement solutions to everyone dealing in preparation and submission of healthcare claims to the ones adjudicating and paying claims for the medical services rendered to patients.

·         Now the HPP Management Group is moving into the new frontier in healthcare reimbursement the Pay-for-Performance (P4P) alternative, the new way how healthcare providers receive their compensation where HEDIS, PQRS and other reporting measures systems become intrinsic modules of our software reimbursement applications. 

                                                                                       

                                                                                        Our Services

·         Billing and Coding

·         HEDIS Guidelines

·         Quality Measures ( Policy & Guidelines )

·         Provider Credentialing

·         Audits ( Medicare & Medicaid )

·         Review of Medical Records

·         Provider Assistance ( Deceased Physician, Relocation or Closing of Practice)

·         Understanding Risk Management

·         Provider Contracting

For More Details:

Paul G. Silverio-Benet

psilben@hppcorp.com  or  psilben@gmail.com

Call Direct: 305-975-1171  

Health Care Consultants

HPP Management Group, Corp

Health Care Consultants – Our Services

·         Billing and Coding

·         HEDIS Guidelines

·         Quality Measures ( Policy & Guidelines )

·         Provider Credentialing

·         Audits ( Medicare & Medicaid )

·         Review of Medical Records

·         Provider Assistance ( Deceased Physician, Relocation or Closing of Practice)

·         Understanding Risk Management

·         Provider Contracting

For More Details:

Paul G. Silverio-Benet

psilben@hppcorp.com  or  psilben@gmail.com

Call Direct: 305-975-1171