Is your revenue cycle bogged down under PDGM? Here are three ways the Simione-HHS merger can help
Shorter billing cycles, cash flow issues and cumbersome new intake and admission processes have turned revenue cycle management under the Patient-Driven Groupings Model (PDGM) into a walk on the tightrope. At many home health agencies, pressure is mounting to maintain a delicate balance and avoid going down.
If your agency is feeling less sure-footed under PDGM, this week’s merger between Simione Healthcare Consultants and Home Health Solutions offers an expanded scope of business services designed to boost clinical, financial and strategic performance.
Simione is an industry leader in clinical and financial operations, cost reporting compliance, data analytics, growth solutions, information technology and project management, talent solutions, and mergers and acquisitions. Home Health Solutions is one of the nation’s top-flight coding and OASIS outsourcing companies, with a keen understanding of the role played in PDGM success by precision coding and patient characteristics such as functional scoring. Together, they are positioned as the industry’s PDGM authority.
“Our merger is designed to offer clients a broader array of professional services to address multiple organizational challenges,” said William J. Simione, III, Managing Principal at Simione. “Revenue cycle management under PDGM is one of the chief concerns for home health agencies right now, and the alignment of services through our merger creates a thorough and multi-faceted approach to assist them.”
Here are three of the ways the Simione-HHS partnership can accelerate the revenue cycle for agencies:
Finding your problem
Agencies aren’t one-size-fits-all operations, and neither are their problems. For example, each provider’s unique patient mix plays an important role in determining reimbursement.
With so many differences between agencies, tracking down the specific weaknesses in revenue cycle management often requires skill and experience. Multiple stumbling points may range from the need for precision coding and adequate information collection at intake to the importance of visit scheduling under PDGM's complex system of LUPAs. Issues such as staffing, communication and productivity take their own toll on the revenue cycle.
HHS knows the complexities of PDGM, and Simione is the industry leader in tracking Key Performance Indicators, with its own benchmarking tool to assess margins, profitability, productivity and numerous other performance results. Together, they offer agencies powerful tools and training to identify problems unique to an agency and take corrective action to maximize cash flow.
Improving your billing
With double the amount of claims in an episode under PDGM, the pressure is on an agency’s billing department for speed and efficiency – but that’s only half the battle.
PDGM requires billing to work in tandem with clinicians to establish new processes and develop operational strategies to keep the revenue cycle moving forward.
Both Simione and HHS are recognized leaders in improving clinical documentation at agencies. Our customized education programs and pre-bill audits can put your billing department on a fast track to improved performance.
Your EMR and other systems and software are a key drivers of your agency’s revenue cycle management. You rely on technology for team documentation, data tracking and reporting to identify important metrics and more. To a large extent, your information technology determines your productivity and controls your financial success.
Simione’s full array of managed IT services can make certain your system and project management efforts keep your revenue cycle moving forward. Whether you are selecting a new system or trying to optimize your existing technology, the consultants at Simione can help you assess, build and implement the infrastructure necessary for success.
Reach out to us
“These are just three of the ways the Simione-HHS merger brings a full package of resources to help agencies deal with the issues holding them back,” said J’non Griffin, who will continue to serve as President of Home Health Solutions under the new company structure.
“We’re excited about the positive impact we expect our merger to have on our clients, and look forward to talking to agencies about how we can help them.”
Let us know how we can help you!
To talk by phone, call Simione at (800) 949-0388 or HHS at (888) 418-6970. Contact us by email here.