Paramount Health Solutions is a company of its time.
The healthcare consulting agency provides a service that was nearly unheard of prior to 10 years ago but is now responsible for helping keep hospitals financially solvent. Three of its four principals are not native-born Americans. Its employees and board members are spread out across the U.S., meeting, collaborating and working remotely – which was their standard practice even before the COVID-19 pandemic. Its clients represent small and large hospitals and healthcare systems from all parts of America. PHS represents a business model that is nimble, microtargeted, tech-savvy and not geographically bound.
Paramount Health Solutions (PHS) started modestly in August of 2018 in Marina del Ray, Calif. Its purpose is to help hospitals catch errors and omissions in patient records that result in missed reimbursement opportunities and payment denials. Beyond improved revenue cycles, accurate clinical documentation and coding present a clearer picture of population health and services provided.
In years past, DRG validation and coding was done by nurses and coding staff. In the last 10 or so years, however, as medical coding has become exponentially more complex, physicians bear a larger responsibility for accurate clinical documentation of their services. Medical education, however, has not caught up with this new reality, as there is little to no training in clinical documentation and coding in medical schools.
Paramount Health Solutions came about when a couple of physicians decided to change their careers from direct patient care and working for hospitals to instead creating a startup specializing in physician-driven clinical documentation improvement.
Bilal Mushtaq, M.D., co-founder and COO of PHS, and Rehan Shakoor, M.D., Senior VP of Clinical Integration, are from Pakistan; Sanjeev Kumar, M.D., Senior VP of Revenue Cycle Operations, is a native of India. The three physicians, now on the PHS executive team, formed a strong bond as co-workers with similar roles at Community Health System, and years later came together to launch their new business.
PHS got a boost in May 2020 when it was acquired by Spectrum Health Partners, a large Nashville-based healthcare consulting firm. As a result, the PHS headquarters moved to Franklin, a bedroom community on the outskirts of Nashville. The company’s main office is now located near the hub of the U.S. healthcare industry. However, its physical location has never been a major factor in the company’s business model.
PHS doesn’t need a big building with a shingle out front and people sitting in offices manning phones – they work from their homes and reach out to clients they know personally from a combined 35 years in the U.S. healthcare industry, as well as following up on referrals they receive from satisfied customers.
With Electronic Medical Records becoming the norm under the Affordable Care Act in 2010, the PHS physicians are able to review and evaluate patient records through secure portals from wherever they may be.
However, Mushtaq, Shakoor and Kumar make a point of personally meeting with clients and their staff at the beginning of any large project.
“We work with clients as their partners and allies rather than as vendors,” said Mushtaq. “We engage in dialogue and education with physicians and staff members to help them improve their clinical documentation, DRG validation and coding. Our role is to help and support them, so they are better at their jobs, and the entire hospital or health system is uplifted.”
Although the COVID-19 pandemic has shut down many businesses, the situation actually offers new opportunities for a business such as PHS. Hospitals are stressed by holds placed on elective procedures, drastic changes in their typical operations and allocation of personnel. Paramount Health Solutions is playing a crucial role during the pandemic to help its client hospitals receive full reimbursement for the care of coronavirus patients and all other services.