How can we be sure we are paid back?

Physicians Care Network. Thanks to a thorough, nationally recognized code auditing system, MSO is able to automatically evaluate provider claims in accordance with approved industry coding standards, ensuring consistent payment to physicians and facilities. Our code-editing technology is updated and improved on a regular basis to more effectively enforce current payment policies.

Claims are examined in order to:

• Verify adherence to industry norms.
• Check to make sure the right billing and coding procedures are being used.
• Verify that the relevant documentation has been submitted.
• Increase provider compensation based on the MRA matrix

In what ways does Doctors Care Network guarantee adherence?

Using these tactics, we collect high-quality data and make it accessible to consumers, companies, health plans, and physicians:

• A comprehensive examination of each patient’s medical file, including their medical history, physical examination results, doctor’s prescriptions, progress notes, consultation, diagnostic, pathology, and discharge summaries
• Confirmation that the diagnosis codes are in accordance with ICD 10 – CMS and are backed by the documentation Guidelines for Coding and Reporting
• Encounters recorded and turned in within the allotted time limit

Appropriate coding standards are defined by:

• The Medicare and Medicaid Services Centers (CMS)
• The CPT Coding Guidelines of the American Medical Association (AMA)
• Determinations of National and Local Coverage (NCD/LCDs)
• National specialization and directives from the academy.

Is HEDIS required?

Every regulatory body requires HEDIS annual reporting. Because of this, in order to know what health plans need to report, providers and the people who work for them need to familiarize themselves with HEDIS.

How does it operate?

Using the National Committee for Quality Assurance (NCQA) approach, which has extended the size and scope of HEDIS to include measurements for physicians, PPOs, and other organizations, all data is thoroughly examined by NCQA Certified auditors to assure the validity of HEDIS results. The Healthcare Organization Questionnaire (HOQ) and the Interactive Data Submission System (IDSS) are two of the HEDIS Data Submission tools used to collect data.

The secret to the patient’s care and security is anticipation.

To guarantee efficient and secure patient care, we plan and coordinate all activities related to patient care and disseminate information to all parties involved. We ensure that the provider team is aware of the care requirements in advance.

The Doctors Care Network method

• Coordinating as a team to enhance patient access and care quality
• Effective communication channels, such as daily hospitalization reports
• Assure patient follow-up following hospitalization.
• To guarantee care coordination, patient retention, and utilization level reviews, track, monitor, and actively manage assigned patient cases.
• Get all the components needed to create a personalized patient care record.
• Interact with patients’ doctors and other staff members at the clinic and at other locations to deliver precise and prompt care.

Our comprehensive pharmacy management service includes:

• Arranging and evaluating each medical office’s pharmacy rules and processes
• Creating effective prescription drug prescribing and management systems
• establishing quality standards in accordance with CMS’s Pharmacy and Therapeutics Committee recommendations for all medications used by PCP
• Maintaining records to ensure the caliber, volume, and promptness of work completed
• Covering developments and trends both inside and outside the hospital
• Preserving the level of care competency for patients of all ages as specified by the orientation guidelines
• Putting in place warning protocols for high-risk drugs and prescription interactions for elderly people

Boost earnings while keeping the occupancy rate at 100%.

With every one of our prior clients, our tried-and-true approach produced fantastic outcomes. With Florida Doctors at Home, all of your customers with medical and mental health concerns can access a round-the-clock on-call service.

The full spectrum of adult psychological care is covered by our service. These experts are accessible at your location in addition to the round-the-clock help line.

You can have access to an on-site MD or ARNP from FL Doctors At Home with our round-the-clock On-Call Service. As a home doctor is provided to the patient’s home, this will lower the danger of hospitalization for your clients and provide comfort to ALF owners and staff.

Additionally, we assist you in maintaining AHCA compliance by giving your employees the necessary in-service training.