For Specialized Care Providers

Why choose Health Systems Management Network, Inc. to help your organization?

Special Providers face special needs and issues in today’s healthcare arena. If you have faced, or are facing, any of the following issues, HSMN can help you as they have successfully helped your peers in these same areas. We are multifaceted in that HSMN has worked with small clients and clients with more than 200 clinics nationwide. Let us help you.

• Clinicians working for your organization don’t understand the difference between clinical appropriateness and “Medical Necessity” as defined by the HCFA (CMS). You need educational support on site but are having difficulty gathering the medical staff for educational sessions. The organization would like to have educational modules specific to your disciplines available for the physicians to study on their own time.
• You are under or about to be under scrutiny by the OIG and want to ensure you are in compliance with all billing guidelines for your special services. Your organization is finding a higher than usual denial rate for its claims and needs to reduce it immediately.
• You need to submit or resubmit claims and want a quality review to ensure that your organization is meeting all of the guidelines.
• You have many sites and are concerned about the integrity of the data going to your central laboratory site for billing purposes.
• Your organization sees a dip in revenue for one of your regional sites and needs an assessment of what has happened.
• Your organization needs a financial and operational assessment of the business office operations of a large number of your clinical sites.
• There is concern about the business processes in your central billing office and there is also concern about the integrity of data on the basis of the age of the current Information System.