Consultation

Business & Clinical Management Services, Inc. (BCMS) has been providing practice operations and compliance consultation since 1985. We specialize in Compliance Program Development and Management for Outpatient Therapy Providers, coding, billing, documentation, and compliance auditing and consultation. Call us today to schedule your consultation.

Consultation Services Include:

Practice Operations Consultation

Available for both start up practices and established practices, our consultants help you navigate your unique needs, issues and questions and provide the guidance you need to mitigate operational risks and demonstrate pro-active compliance measures.

  • Start Up Practices---services include planning from ‘ground zero’ to ‘opening day’---the ‘what, when & how to’ set up a private practice. Special emphasis on:
    • Business office processes and policies and procedures for: patient registration, patient rights, insurance verification, coding, billing, claims processing and HIPAA/HITECH
    • Provider credentialing, enrollment and contract analysis
    • Personnel and clinical infrastructure planning
    • Fraud & abuse prevention and risk mitigation via the development and implementation of a comprehensive Compliance Plan
  • Established Practices---services include surveys, reviews and audits of existing systems and operations followed by action and intervention plans for enhancement and/or correction

Site Visit Surveys include but are not limited to:

  • Physical plant survey for ADA, OSHA & HIPAA compliance
  • Billing, collection & business office review for regulatory and risk management compliance
  • Documentation & coding audits for regulatory and professional standards compliance
  • Workforce orientation and ongoing education in, minimally
    • OSHA Bloodborne Pathogens
    • Hazardous Substances
    • HIPAA & HITECH
    • Professional and/or positional competencies
  • Human Resources Management for labor law, professional standards and personnel and medical file compliance
  • Policies & procedures review for regulatory content compliance
  • Summary reports, recommendations for enhancement and/or corrective action, provision of implementation resources
  • On site staff education based on site survey findings or pertinent topics

Claims Management & Appeals Execution or Consultation Services include:

  • Medicare & commercial payer record submission guidance
  • Appeals implementation and management including, but not limited to:
    • Pre & post payment audits by Medicare Administrative Contractors and or commercial payers
    • Comprehensive Error Rate Testing Audits
    • Recovery Audit Contractors’ Audits
    • Medicare as a Secondary Payer Audits
    • Program Safeguard and Zone Program Audits
    • Administrative Law Judge

HIPAA/HITECH consultation includes:

  • Gap analysis and risk assessment guidance and resource provision
  • Notice of Privacy Practices and Patient Rights
  • Privacy and Security administrative, physical & technical standards compliance direction, process implementation, self monitoring, auditing and reporting guidance
  • Policies & procedures review, enhancement and/or implementation
  • Workforce education
  • Business Associates & Business Associates agreements

OSHA and ADA Consultation includes:

  • Building/clinic inspection for physical plant compliance
  • Exposure Control Plan (BBP) functional application
  • Hazard Communication Program functional application
  • Internal & External Disaster & Health & Safety Programs functional application
  • Policies & procedures review, enhancement and/or implementation
  • Workforce education and ‘train-the-trainer’ programs

Compliance Plan for Third Party Rehab Billing Services Provide:

  • Sound content based on regulatory and risk management validated resources
  • Personalization options for each policy and procedure requiring just a few key strokes
  • Practice specific customization by allowing the user to choose options
  • Provide a user-friendly educational tool for work force orientation and training
  • Policies and procedures that meet:
      • The OIG’s Guidances for Third Party Billers
      • HIPAA/HITECH requirements for Business Associates
      • OSHA requirements for business owners
      • Personnel & workforce requirements set by the Department of Labor
      • Compliance Operations
      • Education & Training
      • Monitors, Audits & Assessments
      • Records Management
      • Billing & Collections
  • Compliance and Support Forms and Resources
  • Provider-Client Compliance Guidelines & Resources