The underlying foundation of Value-Based Care (VBC) is not based on limiting care or quality. It’s about aligning optimal patient care with financial benefit – for the patient, for the doctor, and for the unsustainable cost of healthcare to our overall economy.
Our Join Our Team - RCM opportunity is a vital and proactive solution for you and your client TINs, physicians, clinicians, ACO and Advanced APM members, and all payor classes (Medicare, Medicare Advantage, Medicare Shared Savings Plans (MSSP), Medicaid, Commercial – Insured and Employer Self-Funded Plans, and other Risk Based Reimbursement Plans).
We work with RCMs to help their clients meet the CMS Final Rules compliance challenges, improve efficiency, and increase billing encounters and reimbursement. Most important for your RCM, earn an easy new revenue stream at NO cost. And this is obvious - when your clients’ reimbursement increases, so does your revenue.
As an RCM, you can and should play a key role in helping your clients meet and exceed compliance requirement benchmarks and targets. In addition, help them maximize reimbursement wherever possible. With your help, we can extend our category offerings to your clients, which you will receive a share of any resulting service fees.
We collaborate with you to help them properly address their RAF Compliance, Patient Outreach, Health Information Exchange, and (if they are MIPS eligible) MACRA optimization issues (see our webpages and flyers for the important details on each category).
Compliance is Now Incentivized
Though most TINs did a good job meeting compliance in the past, due to new complexity and the failure of vendors and health plans to provide TINs and their providers with the proper expertise, tools, and/or training, 98% are NOT meeting all requirement benchmarks and targets on at least one, but for some, all four categories.
Administrators even boast about their Quality Scores, robust risk adjustment, abstract coding teams, QA audit teams, and provider education. Unfortunately, too many are still apathetic about verification and action needed, because up until now, the requirements have not amounted to any significant increase in revenue. But this has now changed.
All category services are on a Clinic-by-Clinic basis and tailored to each clinic’s specific needs, which can change from one year to the next. Each category offering is predictable and annually renewable. The fee schedule included in our contract means Live Well A.P.S. will remit a revenue share back to your RCM.
In a 30-minute Zoom call, we will talk about providing you with a financial snapshot, using data you supply us on a few of your client TINs, which will show you how much more revenue we can help them can capture. And provide you with higher prestige and revenue.