For hospitals and health systems, the scale of operations may be considerably larger, but the principles and practices required for fiscal success remain the same. Attention to detail and an eye toward continual process improvement define our inpatient solutions. Often serving in a collaborative role with in-house teams, Amura Health Solutions offers interim or ongoing contract services ranging from Revenue Recovery and Compliance Reviews to Operational Assessments & Oversight.

Services

Transcription

From the Doctor's Lips to Your Bottom Line

What your physicians have to say about each care episode has a big say in how you'll ultimately be compensated for them. Accurately documenting services rendered through precise, easily interpreted transcription is a valuable part of the medical record and serves as the launching point for the entire revenue cycle.

 

Amura Health Solutions offers fast, cost-effective contracting of this all-important initial step. Our transcription services are completely digital. Audio files are securely stored and accessible online. We offer multiple levels of dictation turnaround time, with stat dictation usually completed in less than 24 hours.

 

Where we transcend the largely commoditized nature of transcription services is in our holistic perspective. Unlike singularly-focused transcription vendors, we understand first-hand the relationship between creating optimal records and the maximization of reimbursement. Quality transcription's impact on the immediate downstream process of coding can't be underestimated. That's why we diligently provide feedback to physicians in an effort to encourage more descriptive dictation and clearly establish medical necessity.

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Coding

Fluent in the Language of Reimbursement

Translating clinical documentation into the correct codes for billing is perhaps the most difficult task in the healthcare revenue cycle; yet it may well be the most critical in realizing full, prompt compensation. The number of providers opting to contract this vital function continues to grow, because experienced coders possessing both the left-brain analytical reasoning and the right-brain interpretive ability required are in high demand and short supply.

 

Amura Health Solutions' certified coders are so immersed in the intricacies of clinical coding for inpatient, outpatient and physicians, it's like their second language. Our coders' knowledge of the diverse variables that impact the assignment of codes is vast, and their sole pursuit is to accurately capture reimbursement within the context of CMS mandates, AMA guidelines and regulatory/compliance requirements. Ongoing education is simply part of their job description. And, with the increasing coding complexity of ICD-10 requirements, their unique skill set is in-demand now more than ever.

 

As with transcription, the broader perspective we bring to coding includes its effect on the revenue cycle as a whole. Our exposure to facilities across the U.S. empowers our coders to spot trends and recognize opportunities for improvement. We encourage, and in some cases insist upon, the sharing of insightful feedback with providers.

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Compliance Reviews

From Knowing Where You Stand to Developing a Plan

With the emergence of rigorous federal and state standards, such as Medicare laws, regulations, reporting requirements and CMS instructions, compliance has become a significant challenge. Eventually all providers will be required by the government to have formal compliance programs and designated compliance officers. What's more, according to federal sentencing guidelines, CEOs or Board Members will be required to institute and have knowledge of their enterprise's compliance program.

 

Amura Health Solutions has the expertise and the practical insight to perform complete compliance audits, develop and implement compliance plans, work in concert with an internal compliance officer, even serve as a provider's outside compliance entity.

 

Ensuring that both structures and processes are in place for ongoing compliance review, analysis and improvement, we can help insulate you from the adverse effects of noncompliance. As an outside entity, we can offer the autonomy and anonymity that will best ensure your facility is functioning as it should. This includes a hotline where potential violations may be reported in confidence.

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Revenue Recovery

See What You've Been Missing

Chances are, your enterprise is leaving money on the exam and operating table as a result of not being paid correctly according to health plan contracts, government fee schedules, or both. The lost revenue can be significant, especially for inpatient facilities.

 

With our extensive background in both coding and contract negotiation, Amura Health Solutions can help you unearth instances of underpayment and recover the funds you're due. Our ability to fully understand and interpret the intricacies of the contract that's in place, as well as the corresponding medical records, enables our specialists to consistently identify missed revenue opportunities. Typically, we go in and analyze closed, zero insurance balance care episodes, beginning with your high-value encounters. More often than not, our forensics work yields unclaimed revenue that goes directly to your bottom line.

 

When our revenue recovery efforts reveal a pattern of underpayment, our experts identify the root cause in and can work with your employees to develop best practices to address the issue and minimize your exposure to similar errors going forward.

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Physician & Staff Education

It's Not Brain Surgery, It's Billing

The subtleties of the revenue cycle are lost on many doctors and their teams. That's understandable, given their laser focus on care delivery. However, with even a modicum of ongoing training, these bright individuals can be influenced to change their documentation habits to the benefit of the revenue stream.

 

While issue-specific physician education is a recurring theme throughout Amura Health Solutions' service offerings, our more formalized education efforts have proven extremely effective in changing the behaviors of clinical staff over time.

 

Our instruction may be administered in three ways:

  1. Direct feedback mechanism – Our teams will review a physician's clinical documentation offsite and provide detailed instruction with regard to improvements that would increase reimbursement or compliance.
  2. Face-to-face with physicians – One of our teams can administer an onsite education session on a topic, such as best practices for quality documentation.
  3. Remote education session – Similar to our face-to-face session, only conducted via web-based video conferencing to contain costs.

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Revenue Cycle Management

Realize the Synergy of Our Core Services Combined

Maximize the value of our relationship with our complete revenue cycle services package. When providers combine transcription, coding, billing and collections through Amura Health Solutions, the whole is greater than the sum of it parts. It's in the expertise we bring to each phase, the way we approach the entire process, the energy we expend educating our staff, and the way we proactively interact with you, the client.

 

We remove the pressure of dealing with the revenue cycle, as well as the expense of salaries and benefits. With healthcare reform ramping up the complexity through ICD-10 and intensified compliance requirements, now's the ideal time to utilize the expertise of Amura Health Solutions. Let us worry about staying current with regulatory changes and payer contracts, while you focus on clinical excellence.

 

Our revenue cycle management experts will work remotely in your billing system, so you own all of the data and can easily run reports independently. Our methodology, proven effective in numerous provider facilities, places a premium on thoughtful, detail-oriented implementation as well as ongoing interaction. In our experience, simply fixing problems for clients is actually a disservice. Making you aware of recurring coding or billing problems through constructive feedback makes the most sense for everyone involved.

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Support Services & Consulting

Access Our Industry Expertise and Thought Leadership

Amura Health Solutions' expertise reaches beyond revenue cycle procedural know-how and features a wealth of direct knowledge on management strategies and oversight within the healthcare space. Our top-level team members offer insightful, accomplished consultative services in the following area:

Operational Assessments & Oversight

From an onsite, overall operational assessment to a narrowly focused evaluation of a single process, we provide hands-on direction and process re-engineering guidance aimed at maximizing efficiencies and improving profitability. Operational areas commonly assessed include: patient flow, staffing, supply chain, revenue cycle management, regulatory compliance, etc.

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