Paramount Health Solutions (PHS), a provider of healthcare revenue cycle management services, announces the relocation of its headquarters from Marina Del Rey, Calif., to Franklin, Tenn. The move is the result of an acquisition by a group of Franklin-based investors.
“Upon reviewing the services being offered by the talented and experienced team at Paramount Health Solutions, it became an easy decision to make the investment necessary to purchase and grow the company,” said Mark Hartman, who now serves as Chairman of the Board of Paramount Health Solutions. “Providing a service that can directly help improve documentation at a hospital is the best way to assist our clients in turbulent times, and PHS’s services provide a winning solution for hospitals, patients, physicians and payors.”
Dr. Bilal Mushtaq, M.D., co-founder and chief operations officer for Paramount Health Solutions, said, besides problems caused by the COVID-19 pandemic, “hospitals and healthcare systems are in a challenging time as a result of several factors, including ICD-10 coding, which was enacted in 2015 and requires a higher level of specificity, value-based care models designed by the Centers for Medicare and Medicaid Services, as well as an increase in denials by payors.” He said it is estimated that hospitals lose an average of one to five percent of net patient revenue capture annually, which can translate to roughly $22 million. “In addition,” he said, “many hospitals have a difficult time finding and retaining adequately credentialed and experienced staff for coding and CDI.”
Paramount Health Solutions fills this need by conducting its work both in-person and remotely, serving hospitals and health systems of all sizes and geographic locations throughout the U.S.
The move to Franklin, a town on the outskirts of Nashville, places Paramount Health Solutions into the heart of the nation’s healthcare industry. According to the Nashville Healthcare Council, more than 500 healthcare companies have operations in Nashville and work on a multistate, national or international basis. Nashville is also home to nearly 400 professional service firms (such as accounting, architecture, finance, and legal) that provide expertise for the healthcare industry.
“The Paramount Health Solutions leadership team consists of individuals who have executive experience in healthcare and hospital operations, strategy, clinical documentation improvement, revenue cycle management, denial management, DRG validation, and using data and analytics,” said Wesley Littrell, president and CEO of Paramount Health Solutions. “By supplementing these skill sets with expert clinical knowledge as physicians, they are able to bridge the gap between the clinical and coding languages, allowing all stakeholders to get on the same page.”
PHS’s unique physician-led DRG (diagnosis related groups) validation process captures coding errors and omissions related to patient care, leads hospital teams in clinical documentation improvement (CDI) initiatives and utilizes quality metrics and technology to ensure that bills are as accurate, specific and thorough as possible to avoid denials from insurance companies and government payors. The Paramount Health Solutions team reviews the charts in accordance with both coding and clinical guidelines and provides feedback and guidance to providers and coders to ensure that best practices are being followed.
Dr. Bilal Mushtaq, M.D., co-founder of PHS, along with company leaders Dr. Sanjeev Kumar, M.D., and Dr. Rehan Shakoor, M.D., early in their careers received specific training in clinical documentation and made it the focus of their life’s work. The three physicians went on to earn Coding and Clinical Documentation Improvement (CDI) credentials and served in various leadership roles at different organizations related to DRG Validation (DRGV), CDI programs, implementation of training programs, provider education and revenue cycle management.
At one point, all three physicians worked for Community Health Systems, with each responsible for approximately 40 hospitals across different regions of the U.S.
“In medical school and during clinical training, physicians don’t receive coaching on the business side of healthcare and the importance of clinical documentation improvement,” Dr. Mushtaq said. “And yet, hospitals are dependent on the quality of clinical documentation by physicians in order to accurately capture the care that was given and the resources that were used so that the hospital can receive the most accurate level of reimbursement for the care.”
Dr. Mushtaq saw an entrepreneurial opportunity to create a new physician-led business using the skills he had acquired in DRGV and CDI. He observed that regardless of which type of hospital – whether for-profit or non-profit, and no matter the geographic area, there was an urgent need for physician-led DRGV and CDI processes.
In the fall of 2018, Dr. Mushtaq co-formed Paramount Health Solutions, and was joined by his colleagues Dr. Kumar and Dr. Shakoor. A year later, Wesley Littrell, an accomplished healthcare executive based in Nashville, who had been serving on the board of Paramount Health Solutions, accepted the additional role of president.
Drs. Mushtaq, Kumar and Shakoor have a combined 35 years of experience in DRGV and CDI and have reviewed more than 200,000 records yielding more than $100 million in findings.
The new investors from Franklin, Tenn., are led by Ken Doran, who serves as the CEO and President of Spectrum Health Partners (SHP). SHP provides a full scope of healthcare consulting to all types of healthcare organizations through interim management, financial and transaction advisory services.