OPTIMAL    
 REIMBURSEMENT
STRATEGIES

Maximizing Reimbursement for Home Care Agencies

Why Should You Contact Optimal?

Medicare's Home Health Prospective Payment System (PPS) is probably the most confusing of all home health payers, acronyms and terminology such as:

  • SCIC
  • LUPA
  • PEP
  • Therapy Threshold
  • Outlier

can easily mislead untrained billing personnel into incorrectly submitting claims and costing the agency thousands of dollars of which Medicare will never pay!

We provide the following expert services to insure that you receive 100% reimbursement for services rendered:

Revenue Recovery- This service is at no risk to your agency. Our fee is based simply on a percentage of additional revenue that we recover for you! And unlike other billing companies that simply identify the claims that were paid incorrectly, and advise your untrained or overworked staff to correct the claims, we access the Medicare claims system offsite and adjust the claims so as not to disturb your agency's processes.

Billing Outsourcing- Many options available, customized to suit your agency's needs. Don't let your reimbursement be put aside if your billing staff takes vacation or medical leave. We also provider interim billing services for job vacancies while you recruit and hire a new biller.

Training Modules- PPS training at your office or ours, for individuals or groups.
Our training modules include:

  • PPS Home Health Billing-Beginner, Intermediate, and Advanced Levels
  • Hands On Direct Data Entry Training
  • PPS 2008 Billing Training  

A/R Analysis- Let us evaluate your accounts receivable and develop processes to expedite cash flow.

Billing Operations Review- Is an in-depth review of your agency's billing and work flow processes to identify opportunities for improvement and implement new processes to improve your revenue cycle.

Process Improvement Teams- These agency wide teams have been proven to substantially reduce claim errors and foster teamwork between your clinical and billing staff.

Interim Management- We can develop improvement plans or carry out yours in times of employee transition(s), reorganizations, acquisitions or mergers.

Teambuilding-Is employee morale lacking? Is your agency going through a corporate change? Would you like to easily recruit and retain high-producing employees? Studies have shown that a happy employee is a productive employee, we have proven organizational development techniques to inspire team members to go the extra mile!

Contact Us for a No Cost Consultation!

 

 

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