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Health Care Compliance and Revenue Cycle Services

The HORNE team incorporates a comprehensive approach to health care compliance and revenue cycle services.  Our team includes professionals Certified in Health Care Compliance®, Certified Professional Coders® and Certified Healthcare Chart Auditors.  Services for health care compliance and revenue cycle include:

• Coding and CDM Chargemaster
• Electronic health records (EHR) and meaningful use
• IPOs, ACOs and integration services
• Operational assessments/financial assessments/compliance assessments
• Medical device compliance

Coding and CDM Chargemaster

Health care coding issues can have a significant impact on the bottom line of health care practices. For private hospitals, nonprofit health care groups, physician groups or government facilities, HORNE offers coding and chargemaster services aimed at improved efficiency and enhanced revenue.  HORNE's coding and chargemaster services encompass:

• ICD-10 preparation, transition and education
• Clinical documentation improvement
• Electronic health records
• Medical chart reviews
• Coding audits
• Charge Description Master consulting
• Charge capture assessments and maintenance
• Appeal assistance
• Coding education and seminars
• Expert witness testimony

Electronic Health Records (EHR) and Meaningful Use

From thousands to millions, significant dollars are now available to health care organizations that  implement certified electronic health record (EHR) systems and demonstrate that those systems meet meaningful use requirements. As with many government programs, the path to success can be confusing and difficult to follow. HORNE can assist you in navigating the complex meaningful use process needed to receive your incentive payments, including:

• EHR implementation consulting
• EHR security risk analysis (a core requirement)
• Meaningful use registration
• Meaningful use criteria education
• Meaningful use readiness and attestation

IPOs, ACOs and Integration Services

A multitude of activities are required to bring together the many puzzle pieces of this massive undertaking into a practical, effective operation. HORNE's team works through the many phases of planning, advising, assessing, leading, designing, guiding, creating, conducting, developing, informing, educating, recommending, facilitating, implementing, monitoring and managing.

HORNE services include:

• Educating interested parties on the ACO concept
• Facilitating discussions and decisions among interested providers
• Conducting focused strategic market assessments to identify, capture and explain all the issues to be faced
• Preparing pro formas, financial assessments, appropriate budgets
• Creating a strategic action plan
• Designing the level of ACO for respective regions
• Guiding technology issues and decisions
• Developing the process by which the ACO will actually manage and coordinate patient care, manage financial risk associated with the costs of patient care, and measure costs and quality in a statistically valid way
• Serving as the catalyst for changing behavior toward improved performance
• Managing and developing the progress of the ACO

Operational Assessments/Financial Assessments/Compliance Assessments

HORNE offers a menu of tailored assessments to provide entities with day-to-day as well as strategic information needed to gain a better position in the health care market.   For hospitals, ambulatory surgery centers and physician practices-both freestanding and hospital owned-HORNE offers:

• Corporate compliance plan assessments
• Corporate compliance plan development
• Customized corporate compliance services (interim management, quarterly reports)
• Revenue cycle assessments designed to enhance cash flow, reduce denials, maximize  efficiency and compliance
• Operational assessments
• Provider-cased assessments
• Financial assessments
• Key performance indicators and other tools for success
• Fee schedule analysis
• Customized development of policy and procedures/job descriptions/performance evaluations

Medical Device Compliance

Ensuring regulatory compliance for medical devices requires an understanding of regulations and policies that are complex and often changing.  HORNE's health care compliance team:

• Performs arrangement testing for contractual and non-contractual activity reported for licensed HCPs
• Designs completeness testing methodology for state law reporting requirements
• Audits aggregate spend and transparency reporting then performs reconciliation of spend data
• Assists in evaluation or developing policies and procedures to promote compliance with Business Conduct Standards
• Assists in User Access Testing for database development and query reporting

For more information on HORNE's health care compliance and revenue cycle services, contact Partner Katherine Watts at kathy.watts@horne-llp.com or call 731.664.3712.