Home Events
    
          McBee Associates - Health Care Financial and Management Consultants
About McBee Associates McBee Associates Services McBee Associates Affiliates McBee Associates Careers Contact McBee Associates
Services
Hospital & Health Systems
Compliance Cost Reporting Denial Management DSH Finance Services Financial Improvement Global Pricing HIPAA Services Information Technology Support Interim Management Internal Audit Regulatory Policy Implementation
Cost Reports Billing Planning
Post-acute Strategic Planning Turn Around Services 276 Transaction
Home Health Care Community Health & Human Services Long Term Care Facilities Physician Group

Next Step
Contact Us:
1-800-767-6203
Print PagePrint Page
Email PageEmail Page
Comment on a PageComment on a Page

Regulatory Policy Implementation
McBee Associates Regulatory Policy Implementation

Billing

Post-Implementation APC Reviews

McBee Associates' APC implementation staff helps institutions around the country establish new charges, revise coding, and test their claims systems prior to APC implementation. From its multiple projects the APC staff developed unique insights into the numerous implementation issues. Its valuable experience is now available to help institutions review implementation success and solve their outstanding issues. Our specific approaches to help ensure an institution is receiving its appropriate APC reimbursements are:

  • Assess Current Charging Practices - APC implementation includs revisions to the Charge Description Master (CDM). McBee Associates reviews the CDM to insure all steps required to establish new charges were completed correctly. McBee Associates also researches and finds answers for any ongoing charging issues.
  • Evaluate Current Coding Function - Modifier use is a significant challenge in APC implementation. While HCFA continues to review, define, and clarify modifier use, McBee Associates' APC team reviews use of current of modifiers and also resolves outstanding questions.
  • Test Outpatient Code Edit (OCE) - Testing the OCE on the claim system is critical to verifying its correct installation. To test the OCE, the results of submitted claims with a combination of codes, procedures, and modifiers are compared against known results. McBee Associates has a set of test data set to verify correct installation.
  • Analyze your Return to Provider File (RTP) - A review of the RTP file provides insights into APC issues. The denial codes for claim returns are summarized and tracked to the root causes. These errors can then be resolved at the source of the problem. McBee Associates assists in RTP file review, summarizes the client's issues, and implements changes to correct identified problems at their source.

New Services Implementation

McBee Associates can help your institution establish rates and billing processes for new services such as Sub-Acute Care, Community-Based Agencies, Ambulatory Surgery, and Hospital Services. McBee Associates can establish rates for services that are reimbursed on a cost-based or fee schedule. We help develop procedures for billing and provide training in such procedures.

Review Current Billing Procedures

McBee Associates reviews the current billing process, fees charged, and reimbursement received to ensure compliance with Medicare/Medicaid regulations.

 
© 2008 McBee Associates, Inc.