Managed Care Contract & Consulting Services
Where in this process can you potentially make or lose revenue?
ANYWHERE!
Would it help your facility to know this valuable information?
- Completing appropriate insurance verification to identify who is the payor for the skilled stay. Don't let all your facility's work go unpaid due to the wrong payor identification!
- Know what needs to be checked upon admission and throughout the skilled stay.
- Learn How to Complete a Managed Care Triple Check to avoid delay or non-payment for all services provided.
- Learn how to use efficient, streamlined systems, getting authorizations, capturing levels, identifying correct vendors, informing businesses of exclusions and much, much more.......
- Ensure that all of your staff knows how to identify changes in condition affecting defined levels of care for managed care patients
- Establish ways to develop and maintain relationships with your managed care groups in order to attract and retain business.
- What if you could capture more revenue, have less headaches, and know how to maximize your managed care contracts?
- What if your staff felt confident in saying "YES" to managed care referrals?
- What if you didn't have to lose out on money & skilled business by the increase in managed care residents?
Mix Solutions will:
- Perform an onsite or offsite audit reviewing managed care system
- Audit managed care claim and supporting documentation reporting findings in lost and uncaptured revenue
- Complete audit with a facility presentation/webinar to discuss findings and present recommendations
Is Your facility leaving money on the table?
DON'T LET ALL YOUR FACILITY'S WORK GO UNPAID
Case Management systems are as vital as Medicare systems in guaranteeing full reimbursement and maintaining profits
What if you had a resource to partner with to identify gaps in workflow or missed steps in managed care best practices, inquiry to discharge through to clean claim billing? Whether it is $300 per claim missed billed or $100,000 in unbilled exclusions for a fiscal year, an audit will provide you an invaluable report to begin building, revising, implementing a managed care strategy leading to success!
Resident Stay From:
1. Pre-admission
2. Admission
3. Managing Patient
4. Billing
5. Reimbursement RCVD
- Currently, Mix Solutions works with healthcare providers in educating and training them in managed care, case management, best practices for managing patient stay, ensuring quality of care, and maximizing profits.
- There are so many steps within the case management process, each facility must build/develop a system that works for it.
Here’s the bottom line:
If you don't take the time to put in place a clear defined managed care system to manage a patient stay and to learn who is “at risk”, paying the bill – then YOU are at RISK, BIG RISK!!!!!!
It is just that CLEAR. Don't leave money on the table or let hard work go unpaid.
What's The SOLUTION?
○ Getting informed & educated on managed care is a START.
○ Facility managed care team should be comprised of qualified, knowledgeable experts who know about managed care inside and out.
○ When looking for a Managed Care Specialist, they should be able to create, design, and implement best practices tailored/customized to your facility.
○ Look for a specialist who can review your specific cases and uncover that lost, missing, or hidden revenue you never knew you had… then train your staff to know how to work with all aspects of managed care from pre-admission to billing at discharge and everything in between.
○ Teaching valuable tools and skills developed to provide excellent care while managing a managed care stay.
○ Implement managed care teamwork utilizing case management best practices and a Mix Solution Case Management Specialist will assist in developing cohesion between all facility personnel working with managed care.
○ CASE MANAGEMENT THAT LEADS TO MAINTAINING AND MAXIMIZING MANAGED CARE DOLLARS!
Case Management
Managed Care Systems Will Shape Our Financial Viability
Say "Yes" to a Managed Care Audit to create a strategy to maximize revenue
Make certain your facility is managing a managed care stay and not leaving any money on the table.