The Project Scope and Specifications: Medical Billing: i. Assess current medical billing practices (from training to working denied claims). ii. Identify ways to modernize and innovate billing operations (should consider the incorporation of the new EHR system capabilities.) iii. Provide recommendations on infrastructure of the revenue cycle. iv. Develop a functional organizational structure with positions, roles, responsibilities tied into workflow processes. v. Establish best practices surrounding metrics, workflows (from service delivery to claim), contracting (third-party player contracting strategies). vi. Consultants to make suggestions/recommendations on the industry’s best practices and the following areas: a. Process Assessment: Conduct a thorough assessment of the current medical billing processes to identify inefficiencies, bottlenecks, and areas for improvement. b. Regulatory Compliance Review: Ensure that billing processes comply with all relevant healthcare regulations. Implement security measures to protect patient data and ensure compliance with data privacy regulations such as HIPAA. Regularly review and update security protocols to address emerging threats and vulnerabilities. c. Revenue Cycle Management Analysis: Evaluate the entire revenue cycle, from patient registration to claim submission, payment posting, and accounts receivable management. Identify opportunities for streamlining and optimizing the revenue cycle...
