Optimizing Healthcare Reimbursement with HAP
Being accurately reimbursed for all the care you provide is essential for maintaining financial stability while delivering high-quality patient care. Navigating complex reimbursement models like the Patient-Driven Payment Model (PDPM) requires more than just conventional scrubbing software.
In this blog, Health Advisory Partners by Aegis Therapies® (HAP) describes a strategic, data-driven approach to reimbursement.
Understanding Reimbursement Challenges
Healthcare providers face numerous obstacles in securing appropriate reimbursement for services rendered. From ever-changing regulatory requirements to the intricacies of coding and documentation, missing even minor details can lead to lost revenue. In fact, approximately 35% of Minimum Data Set (MDS) assessments contain missing codes, leading to inaccurate portrayals of patient needs and reduced reimbursement.
Key Strategies to Optimize Reimbursement
To overcome these challenges, providers must adopt a proactive strategy that integrates compliance, analytics, and expert guidance.
Optimize PDPM Documentation
Accurately capturing resident needs and care provided is critical under PDPM. Proper documentation ensures that skilled nursing facilities receive full compensation for the services delivered, aligning reimbursement with the actual complexity of patient care.Leverage Data-Driven Insights
Real-time analytics empower providers to make informed decisions regarding patient care and financial planning. By monitoring trends and identifying overlooked opportunities, facilities can enhance their revenue strategies.Enhance Quality Management and Compliance
Maintaining high standards of care while adhering to regulatory requirements not only improves patient outcomes but also safeguards against penalties and revenue loss. A focus on compliance ensures sustainable financial health.Utilize I-SNPs for Additional Revenue Opportunities
Institutional Special Needs Plans (I-SNPs) can provide an avenue for optimized reimbursement and improved resident care. Understanding how to navigate these plans effectively can yield significant financial benefits.Refine Financial and Operational Planning
Medicare, Managed Care, and Case Mix adjustments all play a role in reimbursement. Developing a strong financial strategy ensures providers remain adaptable in a shifting payment environment.
How HAP’s Support Enhances Outcomes
While software tools provide basic scrubbing and analytics, expert consultation offers a deeper level of strategic guidance. Health Advisory Partners by Aegis Therapies provides hands-on support to ensure providers maximize reimbursement potential. Unlike generic software solutions, their services focus on individualized training, documentation accuracy, and strategic financial planning.
HAP’s PDPM Coding Consultation process follows a three-step approach:
Submit MDS Coding Data – Providers send resident details and documentation for review.
Receive Expert Analysis & Recommendations – Specialists analyze data and offer coding recommendations, the rationale for the recommendations and the Case Mix Index (CMI) impact.
Access Detailed Performance Reports – Monthly impact reports summarize financial improvements and actionable insights.
Data-Driven Results
At Health Advisory Partners, we don’t just offer recommendations—we provide measurable improvements that directly impact your bottom line. Our in-depth reporting illustrates the financial benefits of our strategies, empowering your organization with actionable insights. In 36% of cases, we identify overlooked opportunities that increase provider reimbursement, with our recommendations adding over $300 per audit to revenue. On average, clients partnering with us experience an impressive 150% return on investment.
Take Control of Your Reimbursement Strategy with HAP
Navigating the complexities of PDPM and other reimbursement models can be challenging, but with the right approach, providers can secure the revenue they deserve. By leveraging expert guidance, advanced analytics, and proactive financial planning, facilities can enhance their financial health while maintaining the highest standards of care.
For organizations looking to optimize their reimbursement strategy, partnering with a knowledgeable consultant like Health Advisory Partners can make a significant difference. Reach out today to learn how expert insights can drive measurable improvements in your reimbursement outcomes.
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