FIRST-Steps-Program

FIRST Steps™ Program

Fully Integrated Revenue Services & Technologies

The FIRST Steps™ Program facilitates hospitals and healthcare systems in streamlining operational efficiencies and strengthening “bottom lines”. Optimal Revenue Cycle performance is achieved through creatively configured customized services and innovative “best practice” revenue enhancing technologies.

MDR™ has segmented its FIRST Steps™ Program’s focus into the following categorical areas:

Cash Acceleration

Provides a team of experienced analysts focused on the implementation of appropriate actions to collect and/or resolve assigned aged accounts. Our team manages all communication with related Payers and patients to obtain payment. Program identifies inefficiencies and provides recommendations for customized ongoing process improvements.

Historical recovery is 30+% of aged accounts providing a significant increase to current cash flow.

Charge Capture—All Payers

Provides proprietary software driven by code pairing set algorithms which reviews all claims that have potential for additional reimbursement. Program identifies suspect claims, reviews the medical record associated with the claim and returns a revised claim to the organization on a contingency fee basis. Historically increases cash by .2%-.5% of reimbursement from all payers.

Payer Search—Self-Pay

Provides advanced patent pending data mining technology driven by algorithms which looks at inpatient and outpatient claims and identifies, Medicare, Medicaid/Medical, and dual eligible enrollees. Program does not interfere with current vendor arrangements or existing processes and is contingency fee based on paid claims results.

Historically increases cash by .5% to 2% of net government reimbursement.

Transfer DRG—Medicare Inpatient

Provides advanced non-intrusive technology driven by algorithms which performs an automated detailed variance search of all Transfer DRG claims regardless of size. Program does not require any upfront charges, set-up fees or budget allocation.

Historical recovery is .5%-1% of all Transfer DRGs.

Payment Review—Commercial

Provides a review of all commercial payments for proper payment in accordance with negotiated contracts. Appeals are prepared for negotiations with payers.

Historically increases cash by .1%-.3% of commercial reimbursement.

Disbursements Audit

Provides proprietary technology and experienced team of professionals that identify past disbursement errors, validate results, and file claims for reimbursement. Program offers technology on a continuous basis to detect disbursement errors before payments are made, saving time and money.

Historically decreases cash disbursements by .5%

Out-of-State Medicaid

Provides proprietary technology and experienced team of professionals specialized in dealing with the complexities of Out-of-State Medicaid billing. Our team solves the biggest challenges in the areas of eligibility verification, pre-certification/authorization, provider enrollment, inpatient/outpatient billing, and appeals.

Cash Acceleration--Self-Pay

Provides upfront monthly non-recourse cash payment to clients at net historical self-pay collection rate plus a 15% premium..Accounts are worked in the hospital’s name and are handled without client intervention.

Increases cash by 15% of historical net cash on self-pay.

ICD-10 Implementation

Experienced team reviews all aspects of clients IDC-10 readiness and then develops and implements a transition plan, including recommendations and risk mitigation strategies.

Interim Staffing

Provides temporary and/or long-term staffing of business office and other revenue cycle leadership and staff personnel. All interim staff provided are mentored, trained and supported by our Partner’s experienced team.

Revenue Cycle Outsourcing ("Virtual Business Office")

Provides all revenue cycle staffing, dashboard reports, integrated use of advanced proprietary support technology and leadership oversight by our Partner’s experienced team.