How a Physician’s Passion for Coding Can Benefit Hospitals throughout the U.S.

 

U.S. Hospitals are being stressed and tested as never before.

Healthcare organizations are straining from the COVID-19 pandemic in addition to rapid changes in DRG and coding guidelines, the transition to pay-for-performance reimbursement models, and the expansion of third-party audits. The result is millions of dollars of revenue at risk and hospital stability – and even survival – on the line.

Dr. Bilal Mushtaq, M.D., asserts that the business he co-founded and invested in, Paramount Health Solutions, is well-positioned to live up to its motto, “Helping Hospitals Thrive.” Dr. Mushtaq was trained in CDI/DRGV early in his career – a skill he and most physicians do not learn in medical school. Soon it became his total focus – so much so that he studied and attained coding certification from the American Health Information Management Association (AHIMA).

Over the next 10 years, Dr. Mushtaq successfully led clinical operations in revenue cycle management for a diverse range of healthcare organizations. He worked for several hospitals before accepting a role with Community Health Systems as a Regional Clinical Documentation Improvement (CDI) Director, responsible for over 40 hospitals.

Over the course of his career, Dr. Mushtaq had frequent dealings with two other physician CDI/DRGV specialists, Dr. Sanjeev Kumar and Dr. Rehan Shakoor. They were top of mind when he decided to start his own consulting company.

Dr. Mushtaq said, “When I created Paramount Health Solutions, I wanted to bring together the best in the industry by partnering with my colleagues, Dr. Kumar and Dr. Shakoor. We’ve been together at different firms and hospital systems for over 10 years. When I founded PHS, I knew I had to bring on people I trusted and relied on. Who knew how to review charts and are keenly aware of the barriers and challenges faced by hospitals. We’ve been on both sides of the fence, as hospital administrators and as consultants.”

Dr. Mushtaq went on to say, “That’s a strength of our company. When we get on a call with a client to talk about our recommendation, we know it and we stand by it. The rebuttal process is much smoother because we’re the ones who have had eyes on the charts, and the recommendations have been reviewed by our team. We’re well prepared. All three of us have had experience reviewing charts and finding the best quality of documentation that reflects the true clinical picture of the patient’s stay.”

Dr. Mushtaq said Paramount Health Solutions offers a number of customized, targeted services to help hospitals find opportunities, correct patterns of inaccurate clinical documentation and coding, capture a more accurate clinical picture, and reduce denials by submitting the best possible claims. All of these services follow strict coding rules and guidelines.

While finding lost revenue opportunities is a major benefit, the PHS team also helps with quality metrics and providing targeted education to physicians and staff for improved performance and process change.

“By engaging and educating physicians, we can achieve sustainable results in quality, compliance and reimbursement,” said Dr. Mushtaq. “Physicians are more likely to listen to and relate to other physicians. There is a trust factor that is very important to us.”

Paramount Health Solutions is a company of practitioners who are passionate about accurate documentation and coding, and helping hospitals thrive.

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