On March 1, 2015, Medicare instituted and new policy called Prior Authorization for Hyperbaric Therapy for Non-Emergent Conditions.  This 3-year model outlines specific documentation requirements for reimbursement of this service. Michigan, Illinois and New Jersey were selected as participants due to their high incidence of over-utilization and improper reimbursement over the past few years. Since the inception of this new policy, there has been much confusion leading to unnecessary payment delays or outright denials for reimbursement for this service. 

​Our knowledgeable and experienced team is prepared and ready to help you get back on track and overcome this issue for the long term. Please contact us today and we will get back to you very soon. 

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Keep More of Your Own Money: You Can Do This Yourself

In today's fiscal climate it is becoming more and more important for hospitals to develop, manage and operate clinically sound departments that provide a positive contribution to their financial bottom line. Up to current times, many hospitals have or are currently utilizing outside management companies to equip, support and manage their hyperbaric and wound care services. These service arrangements can cost a single facility hundreds of thousands of dollars over the course of a multi-year contract. Why pay someone to provide a service that you can certainly do yourself? 

If you are looking to take full control of your program, address any issues preventing your success or want to add or expand your current service line....we can help. We will tailor our services to meet your specific needs and goals and help you become independent from unnecessary long-term expenditures. Give us a call today or submit your information on our "Contact Us" page and we will be happy to talk with you.  

​​​​​​Are You Compliant? Do You Know Where You Stand?

As of October 1, 2016, the year-long grace period for physicians and providers regarding proper selection and use of ICD-10 codes will end. Any claims from that point forward with "unspecified" codes will likely be denied due to questionable medical necessity of service. From third-party payer's view point, unspecified ICD-10 codes through claims transmission translates as low acuity with low complexity of care and low intensity of services provided to the patient leaving doubt regarding medical necessity. Additionally, denials significantly decrease the timeliness of reimbursement while negatively impacting the financial viability of your service or practice. 

Our certified Compliance Specialist in wound care can provide you a comprehensive and detailed analysis and audit of your clinical documentation, coding and billing to get you on the right track. Audit issues identified are targeted as educational opportunities for documentation and coding improvements. Are you a physician, physician practice, hospital or free-standing facility that needs help? Please go to our "Contact Us" page and get in touch with us. We are here to provide you with the focused help you may not realize you need using a proactive methodology.