If you are a physician or clinician that is paid by your TIN on a fee-for-service system, offered a bonus based on the number of patients you see, or the quality of care you provide … this information is vital to you.

The high cost of doing business has been met with inadequate increases in reimbursement by CMS and increasing administrative burden due to inappropriate commercial health insurer practices. These issues have created an environment of financial uncertainty.

There is a solution, CMS’s Final Rules dictate that you and your TIN must meet MIPS and/or RAF compliance benchmarks and targets to qualify for higher reimbursement. They have also expanded coverage for Population Health programs including broader eligibility criteria and introduced new billing codes that creates new revenue opportunities for providers. But to succeed, Pop-Health must be tailored to the unique needs of your TINs physician group or individual providers. And we will help them do just that!

CMS’s Risk Adjustment Data Validation (RADV) and Transaction Coding of Diagnoses Final Rules, MIPS Final Rules, the National Quality Strategy (NQS), and payment adjustments under the QPP & MACRA have begun. These have and will continue to create a significantly higher risk of lower reimbursement and an audit if not handled properly.

Our Provider Tune Up Platform is a vital and proactive solution for all physicians and clinicians from all payor classes (Medicare, Medicare Advantage, Medicare Shared Savings Plans, Medicaid, Commercial, and other Risk Based Reimbursement Plans).

We offer a comprehensive suite of services:

• RAF Compliance Optimization
• MACRA Optimization
• Population Health / CCM Optimization
• Patient Outreach Optimization
• HIE Optimization

(See our website for the important details on each)

Though most TINs did a good job meeting compliance in the past, due to complexity and the failure of CMS and vendors to provide TINs and their providers with the proper expertise, tools, and/or training, many are missing the target and NOT meeting MACRA requirement benchmarks and targets.

Administrators even boast about their Quality scores, robust risk adjustment, abstract coding teams, QA audit teams, and provider education. Unfortunately, they are still apathetic about verification and action needed, because up until now, fully meeting requirements has not amounted to any significant increase in revenue. This has now changed.

As a stakeholder with skin in the game, you must insist and verify your TIN is dotting every eye and crossing every tee, because if not and no one can explain why, or do anything about it, you should not accept ignorance or apathy as an excuse.  It’s your income that’s affected.

Most health systems and physician groups have policies that state if three or more physicians or clinicians (paid on a fee-for-service system, offered a bonus based on the number of patients they see, or the quality of care they provide) register a complaint against an administrator and/or executive regarding matters that affect their income, those decision makers will be replaced.

You can and should exercise your power and get your TIN management, Ownership, Managing Partner(s), CFO, or Controller to prevent any oversight. And this can start with your helping us schedule a 15-30-minute Zoom call with your decision makers.

All our services are offered on a Clinic-by-Clinic basis and tailored to each clinic's specific needs, which can change from one year to the next. They require very little workload and no additional staffing requirements on your TINs part.

We make the decision on whether to invest in optimization services or stay the course with your ACO, vendor(s), or your own efforts, very easy.

Unlocking Financial Rewards starts with a Pop-Health Analysis, a RAF Verification Analysis, and maximizing your payment adjustment under the QPP begins with a MIPS Category Weights Data Analysis.

To determine the best course of action, we must first find out exactly where you and your TIN are hitting and where you are missing. We will utilize publicly available CMS data, and data your TIN supplies us from their QPP Detailed Final Report, ACO, MA Plan(s), Electronic Medical Records (EHR) system, Practice Management System, and/or other manual sources.

Our Provider Support Platform is the empowering solution that will ensure you and your TIN meet all requirements, improve Quality Scores, provider utilization, care coordination, the ability to act upon information immediately, and create accurate documentation that supports a patient’s diagnosis and satisfies potential Quality Care and CMS / MA audits. In addition, increase billing encounters, efficiency, reimbursement, ACO shared savings distributions, improve patient outcomes, and unlock new Population Health / CCM revenue streams.

Our Provider Partners are the leading professional service providers and consulting firms that specialize in the processes of MIPS (QPP & MACRA), RAF Compliance, Population Health / CCM, Health Information Exchange, and Patient Outreach Optimization for financial ROI.

They support thousands of independent and hospital-based physicians & clinicians, multi-TIN, Medicare Advantage plan providers, and ACO and Advanced APM members. And our MACRA & HIE expert Provider Partner is a CMS Certified Clinical Qualified Registry (a CMS approved entity that collects clinical data from MIPS clinicians (both individual and groups) and submits it to CMS on their behalf for purposes of MIPS. Reporting options are limited to measures within MIPS and the Quality Payment Program).

They are all specialists that possess knowledgeable teams of people that handle all necessary tasks, provide frequent reporting, and useful analysis.

In a 15-30-minute Zoom call, we will review a CMS database look up that we will do on you and your TIN, which will show how much more revenue and reimbursement we can help you and your TIN capture, talk about the required analysis and the easy enrollment process.

Get your TIN Ownership, Managing Partner(s), CFO, or Controller to take a moment to go to our Provider Tune Up webpage to see our supporting materials and download our NCND. Complete and email it to: support@livewellaps.com. Then reserve the Zoom call with us.