We’ve developed a “Frequently Asked Questions” sheet to respond to questions we receive about Paramount Health Solutions’ methods and services, and how we’re different than competitor consulting groups.
This is the second of two articles to help readers gain useful information as you compare outside companies that can help with CDI and DRGV processes at your organizations. Click here to view the first article.
Q: Why is a physician-led review process important?
PHS: Physicians who are experienced and have been credentialed in CDI, DRG Validation and Coding, are much more likely to be able to review a chart and understand how the documentation relates to the current stay, and if the patient has additional conditions that may have impacted the patient’s current condition for admission.
In addition, most physicians tend to be more receptive to engaging with another physician when discussing an opportunity than they are with a nurse or coder.
Q: Will PHS provide targeted, customized, and meaningful education for my physicians and staff as part of your program?
PHS: As part of our contracted services, Paramount will educate your HIM and coding staff as well as your physicians. Our team of industry expert physicians have years of experience leading clinical and coding staff through highly effective, customized training programs.
Our approach is to use the client’s previous documentation data as case study examples to stress the importance of complete and accurate information in the documentation and coding. Through our query data and CDI analytics, we identify trends and providers that require in-depth education on documentation improvement.
Ongoing customized training helps your team members gain knowledge and competencies in their roles. Our expectation is that after working with PHS, at some time in the future, our services will no longer be needed by the client.
We also educate new staff, including physicians and hospitalists, when you have turnover, to get them up to speed as soon as possible.
Q: My staff tell me they are already doing the same things you do, and they don’t want me to bring in someone from the outside. What is your response to this situation?
PHS: This happens initially with most of our clients.
The Revenue Cycle, CDI and HIM coding staff and management typically have concerns that a third party is coming in to replace them. Sometimes they feel the company is coming in to show they are not managing the program well and fear they will be terminated.
That is not at all what we do! We provide physician reviewers who have the experience and expertise that the current staff do not have. Most clinicians/physicians don’t receive CDI/DRGV and coding training in medical school, and therefore, they are doing the best they can. Our goal is to train the staff to be able to perform at their peak while supplementing them with the physician support that comes with a second review.
Q: Why should we consider Paramount Health Solutions versus other consulting firms?
PHS: Great question! Paramount was founded by physicians with significant personal experience, education, and credentials in CDI and DRG Validation. Our physician executives have experience working inside hospitals and health systems as well as serving in consulting roles.
These physicians wanted to start a company that was not only physician-led but where physicians actually review client charts. The proof this works well is the continuous 80% and better physician acceptance rate of our recommendations with our clients.
Our competitors may tout that they have physician-led models, but, in reality, no physician ever reviews a chart – the MDs merely oversee coding auditors, who are not clinicians, who do the actual reviews. Physician-to-physician exchanges are much more acceptable to the physician of record, versus a coding auditor-to-physician exchange.
We also offer a 90-day pre-bill (concurrent) pilot review with a no-risk guarantee. The guarantee is that at the end of the pilot period if we don’t find enough additional revenue for the client to cover our fees, we reduce our costs to the amount of additional revenue found, so the client does not have any out-of-pocket costs.
To request a no-cost 90-day pilot audit from Paramount Health Solutions, click here.