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HEALTHCARE PRACTICE

 

QUALITY STRATEGY ASSESSMENT

Edafio can provide an assessment of your organization’s current state as it relates to your unique setting, payers, and quality programs to help ensure you are compliant with all applicable regulations. Our assessment can also help you identify potential additional revenue opportunities that you may be eligible for.

 

QUALITY PAYMENT PROGRAMS

Edafio Healthcare consultants have extensive experience working with many payer programs in our region. We can evaluate the payer’s quality programs you are involved in and we can help you with a GAP analysis, audit preparation, and best practices in order to position your organization for success. It is important to understand the requirements from each payer in order to avoid future penalties based on your participation or non-participation. In many cases, your performance today will impact reimbursements in years to come.

 

HIPAA

Edafio Healthcare consultants have extensive experience working with many payer programs in our region. We can evaluate the payer’s quality programs you are involved in and we can help you with a GAP analysis, audit preparation, and best practices in order to position your organization for success. It is important to understand the requirements from each payer in order to avoid future penalties based on your participation or non-participation. In many cases, your performance today will impact reimbursements in years to come.

Completing a risk assessment requires a time investment and Edafio can be your resource to take on that time investment and walk you through a thorough Risk Assessment. We will provide you with a very professional and easy to understand deliverable so if you are ever audited, you can hand them this deliverable and it should address most of the questions the auditors will ask. We also offer remediation assistance as an on-going project where we work with you on a regular basis to remediate any issues found in the assessment.

 

PRACTICE WORKFLOW ANALYSIS

Edafio has experience in mapping and template building in many EHR’s and will be there to help you with any of your needs surrounding these tedious tasks. Our healthcare consultants are able to work with you on implementing team-based care and optimizing your care team structure at the practice. We can assist with pre-visit huddles, built in assessments and documentation of clear roles and workflows based on staff type and position. Defining clear job duties, roles, and responsibilities will be a critical, yet effective part of this process.

 

CARE MANAGEMENT BEST PRACTICES

Many insurance payers plans have begun covering care management for their patient populations. Billing payers or getting up front care management fees by participating in innovative payment models like Patient Centered Medical Home (PCMH) or the Comprehensive Primary Care Plus Initiative is a great opportunity for your practice; however, this type of practice transformation requires hands on assistance in order to be successful and audit ready for claims submitted. Careful consideration should be taken in order to ramp up these efforts and assure patient satisfaction and outcomes are top of mind.

 

Edafio healthcare consultants can lead and assist in this effort as desired. We have found that our “hands on” approach is a great fit for ACO groups as well. We strive to ensure the practice and the ACO has the best chance for success in the various quality driven programs.

 

PRACTICE TRANSFORMATION

Edafio takes a multi-pronged approach with Practice Transformation. We believe a combination of focus on Annual Wellness Visits, Transitional Care Management, and Chronic Care Management can truly move your practice to the next level.

 

Billing Medicare or other payers for additional services that the clinic is not providing currently is a great opportunity for your practice; however, practice transformation requires hands on assistance in order to be successful and audit ready for claims submitted.

 

MEDICAID MEANINGFUL USE ASSISTANCE

Edafio can provide assistance for Meaningful Use in many ways. Our healthcare consultants have experience in a variety of services, including improved workflow, calculating patient volume reports, attestation assistance, and pre/post payment audit assistance for Meaningful Use incentive payments

 

CHART REVIEW

Accurate and up-to-date documentation is incredibly important for compliance and patient satisfaction. Edafio can help you understand the impact your EHR has on documentation, and we can help you review all of your documentation for accuracy and compliance purposes. In order to be successful in an audit, it’s important that all of your documentation be up to date and accurate.