Operations ImprovementOperations Improvement Services

As the cost of delivering healthcare continues to rise and the claims submissions process becomes more complex, effectively managing the revenue cycle is more important than ever. While Xanaxx provides a wide range of services, our focus on the fundamentals of business management – such as revenue cycle operations – is often where we deliver the most value.

Operations Improvement: From patient registration and insurance verification to charge master updates, billing, collections and denials management, our consultants have an in-depth understanding of all aspects of the revenue cycle as well as the regulations under which healthcare organizations must operate. This knowledge is rooted in both high level and hands-on experience gained in a variety of healthcare settings, including hospitals, health systems, academic medical centers, managed care organizations, and medical groups. In fact, many of our consultants have had direct management responsibility for operations, billings and collections prior to joining Xanaxx. Simply put, we have the skills and experience necessary to help your organization optimize revenue, improve operational efficiencies and accelerate the A/R process.

For nearly two decades, we have put this experience to the test – achieving measurable results and implementing sustainable solutions.

We approach each engagement as a true partnership. From the development of a “big picture” strategy to the highly detailed and technical implementation phase, our consultants provide hands-on assistance designed to involve you every step of the process – Operations Improvement.

The result is a manageable, yet cost-effective, solution designed around the needs of your organization that works long after our assignment is complete.

Xanaxx`s Revenue Cycle & Operations Improvement Services:

  • Patient Access (Scheduling, Pre-Registration, Insurance Verification, Financial Counseling)
  • Patient Flow
  • Charge Description Master (CDM) Design, Optimization, Compliance and Maintenance
  • Charge Capture
  • Documentation, Coding and Reimbursement
  • Billing and Collections
  • Contracts Management
  • Denials Management
  • Payment Processing
  • Patient Financial Services & Process Improvement
  • Healthcare Information Technology Solutions and Architecture – Operations Improvement

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Coding and Reimbursement ServicesCoding and Reimbursement Service

From DRGs to CPTs, the healthcare industry continues to rely on coding and other reimbursement methodologies for crucial data gathering, payment and compliance. At Xanaxx, we understand that the practice – and business – of medicine can be paralyzed without complete and up-to-date coding and reimbursement system knowledge and accuracy.

As such, we provide coding and reimbursement analytical services to a wide range of healthcare clients on a stand-alone basis or in conjunction with other revenue cycle, compliance or strategic projects. In addition to the expertise of nationally-recognized Certified Professional Coders, Registered Health Information Technicians, Certified Coding Specialists, and licensed Professional Medical Coding Curriculum instructors, Xanaxx offers turnkey coding services through The Coding Source, LLC, an affiliate company founded in 2002.

Clients ranging from medical groups and hospitals to payors, investors and attorneys also rely on Xanaxx to analyze payments based on the appropriate codes and payment schedules, and prepare them for updates to Medicare, Medicaid, workers` compensation and other third party payment systems. Like all of our consultants, Xanaxx`s reimbursement specialists have frontline experience in – and understand the real life application of – the recommendations they provide our clients. Many also have experience in the broader context of revenue cycle or compliance operations.

Xanaxx`s Coding & Reimbursement Services:

Charge Description Master
Accuracy review of CDM descriptions and coding including UB-04 revenue codes, CPT/HCPCS codes, and modifiers. Detailed reports available, including: deleted or invalid UB-04 revenue codes & CPT/HCPCS codes, UB-04 to CPT/HCPCS code mismatching, items with zero charge amount or zero volume.  Corrective action implementation and integration with other related revenue cycle functions.

Professional Documentation and Coding
Auditing, training for physicians and internal coders, independent review organization (“IRO”) services,  litigation support, and due diligence.

MS-DRG (severity driven) Concurrent Documentation Improvement Program (CDI)
Coding and Reimbursement Services
– Proprietary documentation improvement program and tools, including a seven-step plan for optimizing reimbursement opportunities under Medicare’s Inpatient Prospective Payment System by appropriately capturing severity levels for each Medicare inpatient admission. Auditing, assessment, training and implementation focused on identifying documentation and coding improvement needs based on specific clinical indicators for various types of admissions – Coding and Reimbursement Services.

RAC Audit Preparedness
Identification of the key risk areas within audits and denials to aid in self-assessment, establish best practices in preparation for RAC, assess claim readiness, identify potential denials, and develop a customized concurrent documentation improvement (CDI) program. See Coding and Reimbursement Services.

Clinical Laboratory Assistance
Assessment, auditing and compliance consulting for outpatient, hospital, referral and specialty labs.

Home Health and Durable Medical Equipment Suppliers
Compliance assessment and auditing services designed to identify potential risk areas and implement compliance improvement programs. Projects often include close collaboration with client legal counsel.

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Xanaxx Consulting ServicesXanaxx Consulting Services

At Xanaxx, our service areas represent our intimate knowledge of the healthcare industry as well as our breadth of experience across multiple disciplines. Whether you need to improve operating performance, maintain compliance, strategically plan for the future or resolve a dispute, our comprehensive approach and deep experience ensures a seamless solution and proven results.

Xanaxx Consulting Services include:

  • Website Design
  • Healthcare Consulting Services
  • Social Engagement Programs
  • Healthcare Management Training Program
  • Reimbursement Services
  • Information Technology Services
  • MD360 (Marketing) Membership Program

Xanaxx Consulting Services: Our proficiencies in these areas lie in the extensive, hands-on experience of our consultants and our experience as a firm. Our people have been in the trenches of the healthcare industry – in hospitals, healthcare systems, medical groups and other ancillary businesses – at all levels of responsibility. It is this “insider” perspective that we believe is one of the keys to our success.

At Xanaxx, we understand that individual clients face their own distinct set of business challenges. Rather than applying a standard approach to similar issues, we develop solutions that meet each client`s specific needs. Our consultants are known for their detailed approach to client problem-solving and for their willingness to get deeply involved with any sort of organizational challenge you may be facing – Xanaxx Consulting Services.

We work within your time frame, providing support from strategy and assessment through, most importantly, implementation and evaluation of results. Our customized solutions meet your specific needs, can be realistically deployed and are delivered above and beyond your expectations.

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Experience. Integrity. ResultsExperience. Integrity. Results

Xanaxx Consulting Group is committed to providing clients with the three synchronous elements we believe are essential to any successful consulting relationship:

EXPERIENCE
Founded by Noble Nwigwe, Xanaxx Consulting Group is comprised of senior-level professionals and those who support them – all focused on healthcare. Unlike “across-the-board” consulting firms, we possess an uncommon level of understanding of the healthcare industry, and are highly attuned to the latest trends and developments. We believe this healthcare focus and experience is required to address the complexity of the issues our clients face – experience integrity results.

INTEGRITY
As a Xanaxx client, you`ll work with highly qualified principals and staff members who will be active in your engagement from start to finish and who will be available and responsive to your needs. We won`t shy away from providing you with candid advice, and we have the courage to stand by our recommendations.

RESULTS
We are proud of our track record for achieving results above and beyond our clients` expectations. We produce more than just reports and discussion documents; we provide practical, usable, easily deployable solutions that our clients can implement or that can be implemented with our direct hands-on involvement. We complete our assignments in a timely manner, respecting our clients` sense of urgency – experience integrity results.

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Litigation: No Substitute for Experience

Litigation

In litigation, there is no substitute for experience. At Xanaxx Consulting, our exclusive industry focus allows us to offer clients insight into a wide range of legal issues facing healthcare organizations today as well as the objectivity required of an expert witness.

From increasingly complex regulatory requirements to billing issues, reimbursement disputes and transactional, joint venture or other business arrangements gone awry, today’s healthcare organizations face a myriad of risks that too often result in legal action. For nearly 20 years, Xanaxx Consulting has worked with providers and health law firms to manage those risks. Unlike “professional experts,” Xanaxx Consulting’s consultants spend their days on the frontlines of the healthcare business, working with real clients who face real issues associated with some of today’s most common and complicated healthcare-related legal matters.

Litigation: In addition to providing an insider’s perspective on the operational, financial, technical and strategic issues encompassed by our range of services, Xanaxx Consulting’s principals and consultants have significant experience leading independent investigations and testifying with respect to our findings.

Xanaxx Consulting’s Litigation Support Services:

  • Industry standard practices evaluation
  • Medicare/Medicaid fraud investigation
  • Business valuation
  • Transaction disputes involving hospitals, physicians and/or ancillary service providers
  • Facility and professional fee billing issues
  • Internal audit and compliance
  • Managed care finance
  • Reimbursement dispute analysis
  • Customized Analytics

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Enterprise Risk Services

Enterprise Risk Services

Xanaxx’s enterprise risk services/internal audit offers a unique approach in the market combining technical expertise and internal audit principles with true depth in healthcare operations, finance, compliance, information technology (IT), and reimbursement amongst the many other areas of Xanaxx’s expertise. Our team includes seasoned healthcare professionals including Certified Internal Auditors, Certified Public Accountants, Certified Compliance Professionals, Certified Coders and clinicians committed to the internal audit profession with extensive experience dealing with operational, fiscal and regulatory complexities.

Enterprise Risk Services: Our holistic approach to enterprise risks includes assessing risks in six risk domains We utilize a systematic methodology for analyzing organizational, business process, compliance and internal control risks while focusing on identifying practical solutions that emphasize:

Compliance with regulations and various accreditation standards, Effectiveness and efficiency of operations, and
Reliability of financial reporting.

In addition, Xanaxx has IT audit capabilities to analyze IT from every practical standpoint to provide a 360-degree view. Our assessment services provide clients with an integrated evaluation of their IT program, its functional components, and the policies by which they are governed. Xanaxx’s enterprise – wide risk assessments are tailored to meet the organization’s objectives with information gathered to develop an internal audit and/or compliance work plan.

The healthcare industry faces unprecedented pressures to continuously improve the quality of its services, procedures and operations, all while reducing cost and overall operating and capital budgets. Navigating through the expectations of consumers, regulators, payers, employees and governance requires an effective risk management strategy that includes a robust internal audit function.

Xanaxx’s Enterprise Risk Services/Internal Audit:

Assessment of internal audit needs followed by development and implementation of a practical internal audit strategy that includes policies, procedures, templates, tools, technology solutions, and reporting to senior management and governance.

Conducting enterprise-wide risk assessments to develop an internal audit and/or compliance work plan.
Interim management support/leadership services for internal audit and/or compliance functions.
Internal audit consultants in a partially or fully outsourced or co-sourced model for hospitals, health systems, academic medical centers, medical groups, durable medical equipment suppliers, clinical laboratories, and Medicare Advantage sponsors. Operational audits Financial audits Compliance/regulatory audits Information technology audits. +public

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Compliance Program DevelopmentCompliance Program Development

Since the concept of compliance was first introduced by the Office of the Inspector General (OIG), many in the healthcare industry have come to view it as an unfunded mandate and administrative burden. At Xanaxx, our experience has shown us that a solid commitment to enterprise-wide compliance can actually improve an organization`s fiscal and operational performance as well as the quality of the care it provides.

Compliance Program Development: Regulatory and public scrutiny has made it even more critical for healthcare organizations to demonstrate an unequivocal commitment to maintaining a culture of compliance and ethics that is fully embraced and supported by its governing body. Xanaxx has deep experience in helping organizations develop, implement and continually improve such a culture (and all the details required to enhance services in this area), which can also help mitigate any potential exposure to regulatory liability and sanctions.

From compliance program development and due diligence audits to coding education and claim reviews, our compliance consulting services are performed by seasoned healthcare professionals, including Certified Coders and Certified Compliance Professionals, who have worked extensively in all areas of the industry before joining Xanaxx. This experience allows them a deep understanding of the industry, its operational and fiscal complexities, and its regulatory requirements. More importantly, it provides them with a unique appreciation of the issues faced by our clients and the ability to empathize with their challenges. As a result, our consultants fully understand – and appreciate – the importance of developing solutions that support a client`s ability to “do the right thing” and meet business objectives after the assignment is complete.

Xanaxx`s Compliance Services:

Developing and implementing corporate and departmental compliance programs.

Assessing the effectiveness of mature corporate and departmental compliance programs.

Providing compliance education to clinicians and non-clinician work force members, along with focused training for individuals involved in or responsible for revenue cycle.

Designing and conducting audits of documentation, charge capture, coding and billing processes and systems.

Designing and implementing monitoring programs and processes for all components of a compliance program.

Collaborating with clients to craft compliance standards of conduct and policies & procedures that meet their unique needs and obligations – Compliance Program Development.

Assessment and implementation of HIPAA privacy and security, HITECH and ARRA rules and regulations.

Providing assistance to organizations or individuals facing investigation and/or administrative or other sanctions by regulatory or law enforcement agencies.

Functioning as an Independent Review Organization (IRO) on behalf of organizations operating under a Corporate Integrity Agreement (CIA)

Special audits of compliance program effectiveness for due diligence in joint ventures, mergers and acquisitions.

Highly specialized areas include:

Hospitals, including academic medical centers

Physician practices

Hospital and physician integration

Laboratory

Durable Medical Equipment

Behavioral health

Medicare Advantage and Prescription Drug Plans

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Information Technology

Information Technology

Innovations such as electronic medical record (EMR) systems, computerized drug-order entry and e-prescribing can improve the quality of care that patients receive and increase inefficiencies in medical practices.

As medical practice executives and physician leaders plan to meet the challenges of today’s environment, they must have a focus on strategic technology planning. To prosper, health care organizations must be able to use the power of technology. How should medical practices handle IT strategic planning?
Stimulate your thinking about technology. Strategic planning is not a science. It’s a process for helping medical practices think about the objectives they should set if they are to fulfill their missions— and determine the directions to take to achieve their goals. strategic IT planning helps coordinate the efforts of all participants; it requires that an organization bridge the gap between its business vision and its use of information technology.

Information Technology: To begin strategic IT planning in your organization, you need to stimulate technology thinking in yourself and other medical practice leaders.
Assess your current technology situation. You must evaluate factors in several key areas of your organization.

Medical practice

1. From the following list, identify the top three issues your practice faces:

  • Amount of funding for technology purchases;
  • Amount of time for technology planning;
  • Age and operability of current equipment;
  • Efficiency of current practice management software;
  • Expert IT staff employed;
  • Value that administrative leaders and physicians place on technology; and
  • Ease of getting input from physicians, staff and patients.

2. How does your practice implement and integrate technology-related decisions?

Staff

  • Who is in charge of day-to-day technology management in your practice?
  • Estimate the number of hours per week spent on:
  • Technical assistance to staff; and
  • Fixing broken equipment or system glitches.

3. Is the amount of time spent on the above tasks adequate to serve your technology needs? If not, what types of employees or resources are needed?

4. What kinds of technology training do your employees need? What would make them more efficient and comfortable with technology? Have you assessed their current level of knowledge?

5. Assess your workstations (Information Technology). Are there enough for all employees? Are they ergonomically installed?

Financial

1. What is your total operating budget?

2. How much is spent annually on:

  • Hardware?
  • Software?
  • Training?
  • Network development?

3. How could you improve the process for technology purchasing and budgeting?

Internal/external communication

1. Assess the strengths and weaknesses of your organization’s current information systems. What about them works well?

What needs to be improved?

  • Billing
  • Collections
  • Appointments
  • Capturing patient information

2. How does your practice handle incoming telephone calls?

  • Voice-mail system
  • Answering machine
  • Operator sending paper notes

3. Do you get many complaints about the telephone system? What would improve the situation?

4. Is the number of voice, fax and data lines into your practice sufficient to handle current and anticipated volume?

5. Can staff share documents electronically?

6. What percentage of calls are repetitive requests for information that could be provided electronically?

7. Do employees have access to the Internet at their workstations? Do they know how to use the Internet effectively?

8. Do you have an intranet for communications within the organization? Does your management team use e-mail to communicate with key groups of employees? Is it efficient?

Web site:

1. Does your practice have a Web site? If so, how well does it meet goals for communication?

2. Whom are you trying to reach? Do you let your customers (patients, hospitals, labs, other practices) know about your Web site and its features?

3. What content is on your Web site? Who is responsible for content? Do accountable employees have adequate training, tools and resources?

4. Who is responsible for answering inquiries and responding to feedback from site visitors? Is the process efficient?

5. How do you track the effectiveness of your site? Do you use the information for improvements?
Define your IT strategic plan. Once you have evaluated your technological situation, create and define your strategic IT plan. This requires the support of your physicians. They must authorize your approach to gathering your team, including a participating physician, and grant the necessary money and time.

You and your team need to:

Review and define strategic goals of the practice

1. Meet with physician leaders to develop a list of primary business goals for the next few years. These should include:

  • Geographic expansion;
  • New facilities;
  • Addition of ancillaries; and
  • Merger/growth opportunities.

2. As you look to the future, do you see gaps relative to services your group provides? What information services and resources could address those needs? What and how can technology help close the gaps?
Review current technology infrastructure. Summarize your current hardware and software. Outline the strengths and weaknesses of your systems.

2. Determine physical space and management needs. Assess IT support: in-house or third party? Technology takes up room, requires maintenance and costs money.

3. Sketch out network development needs.

Information Technology: Wired or wireless?

Determine technology goals

1. Create a list of IT goals for the next two to three years that support current medical practice processes, as well as the infrastructure requirements of new business initiatives:

  • Look at your reporting relationships. As technology use increases, management reporting lines should be evaluated and changed to ensure effectiveness. Departmental cooperation will be crucial for the practice to use resources efficiently.
  • Summarize your needs for your electronic health records. Do you need a full enterprise solution, new practice management system, document imaging management?
  •  Security is essential and will be affected by electronic storage of patient health information. How will security affect implementation and projected costs?

Create a list of proposed projects

1. Based on the findings above, prepare a sequential list of technology projects. If possible, define time requirements and demonstrate that they are linked to organizational goals.

  • You may need to create, change or eliminate policies and procedures to accommodate the capabilities of new technology. For example, Web access requires a detailed policy on appropriate Internet access and use.
  • Consider continuing education for employees. Allocate project time and resources for training. Long-term funding of technology-related resources is an essential component of any plan.

2. Record projects necessary for continued support of existing technology in your practice.

Define the implementation timeline

  • Use a Gantt chart to show implementation time for each project. Use this document for capital and expense budgeting, too.
  • Measure and evaluate the effect of your IT strategy. Include implementation milestones and other measurements. This will allow early identification of problems.

And don’t forget …

As you go through the process, keep these tips in mind:

  • The people accountable for getting the job done must also be involved in strategic planning. Setting goals and objectives and developing strategies should include key managers.
  • Key managers involved must recognize that strategic IT planning is an important part of their job duties. They must be able and willing to commit necessary time, energy and resources.
  • Remind participants that the future may not meet our expectations. No matter how carefully we plan, threats and opportunities may change.

Therefore:

  • Don’t spend too much time on “what ifs.”
  • Revisit your IT strategic plan at least annually and update it when appropriate to reflect the changing environment.
  • Involve new members of the management team to get fresh perspectives.
  • Ask strategic planning participants to take an organizational perspective that considers the ability of the practice to meet the immediate and long-term needs of patients, staff and physicians.

The exchange of ideas, the sharing of convictions and doubts, and the deliberations are enormously valuable. Strategic thinking activities provide the management team with a strong basis on which to build the future of the organization.

Leading change and implementing information technology often go hand in hand. The key to success in both is a thorough, inclusive planning process. Collect the necessary information, select a well-rounded team, exchange ideas and prepare your medical practice for success.

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Point of Care Technology

Point of Care Technology

As healthcare organizations adopt wireless solutions, it is crucial to take advantage of Point-of-Care (POC) technology. Medical grade displays and mobile cart solutions make it easier to access and update patient information, and create a hands-free workflow that streamlines tasks and makes point-of-care more efficient.

Ease of Motion – Quick adjustment and easily maneuverability at the point-of-care provides:

  • Increased Efficiency: Mobile units support many patients and move with the care providers as they cross the hospital unit, floor or entire facility, and, because critical information is a touch away, healthcare providers don’t waste valuable time and effort to retrieve, translate, and analyze data.
  • Improves Patient’s Experience: Mobile carts ensure that transitions between settings during the course of a visit are coordinated, healthy, and focused – Point of Care Technology.
  • Facilitates Faster, Safer Treatment: The ability to bring information systems to the patient’s bedside creates a better environment for interaction while gathering critical information, and reduces medical errors.
  • True Ergonomic Designs – Create a comfortable work environment for employees:
  • Carts or mounts allow care providers to sit or stand, offering flexibility in terms of eye levels, data entry heights, and ease of equipment manipulation.
  • Enables the caregiver to share electronic information and images at the patient’s bedside, allowing the patient to view without exertion and physical strain – Point of Care Technology
  • Space-Saving Technologies – Place equipment wherever it’s needed.
  • Mobile carts are compact, easily accessible, and stow quickly when not in use.

Point of Care Technology: Xanaxx Consulting Group delivers a variety of cart solutions, integrated with customized features, accessories, and applications to make the job of providing treatment fast, mobile, safe, and accurate.

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Notebook and Tablets

Notebook and Tablets Devices

The next generation of Notebook and Tablet computers has been purposed to serve the healthcare industry’s stringent requirements, bringing powerful tools right to the point-of-care. These portable solutions permit healthcare providers to track assets, chart patient information more accurately, keep information accessible, and increase their overall operational efficiency. Innovative, web-based systems enable providers to view detailed medical history, review test results, and even submit prescription information to the pharmacy, all from the same mobile computer platform.

Notebook and Tablets: In addition to the ergonomic and efficiency needs of any notebook or tablet user, hospital-grade devices must be specifically designed for use in any healthcare facility. They must be lightweight, yet rugged and disinfect-able to permit productive, clean computing in sterile environments. Integrated features such as long battery life, touch-screen displays, and multiple docking options contribute to keeping healthcare providers productive, safe, and error-free.

Confidentiality and security are always important issues in healthcare settings which make authentication features like smart cards and biometric fingerprint sensors essential to keep critical sensitive data from falling into the wrong hands – Notebook and Tablets.

Xanaxx Consulting Group provides the best notebook and tablet computers from leading industry manufacturers, designed specifically for the needs of the healthcare market.

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