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VIE Healthcare's simple 3 step process

VIE Healthcare's

simple 3 step process

Step 1

Schedule a Call

On your initial consultation call, we will want to learn about your goals and how VIE Healthcare® can support you and your team.

Step 2

We Analyze Your Data

The team at VIE Healthcare® will create a customized solution specifically focused on your hospital's needs and the outcomes you want to achieve.

Step 3

You Achieve Rapid Results

VIE Healthcare® will dedicate expertise and resources that support you and your team to your success.

Step 1

Schedule a Call

On your initial consultation call, we will want to learn about your goals and how VIE Healthcare® can support you and your team.

Step 2

We Analyze Your Data

The team at VIE Healthcare® will create a customized solution specifically focused on your hospital's needs and the outcomes you want to achieve.

Step 3

You Achieve Rapid Results

VIE Healthcare® will dedicate expertise and resources that support you and your team to your success.

Start our 3 Step Process

Schedule your call today

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Schedule your call today.

What are the important steps to optimize reimbursement for your high-cost pharmaceuticals and laboratory testing?

Here are five keys:

1. Document and code. Verify that prescribing physicians have adequately documented the order in the patient chart and that the medical records department recognizes the order and uses the ICD-10 procedure code.

2. Review managed care contracts. Review your managed care contracts in depth of top payers for specific clauses pertaining to high-cost pharmaceuticals and high-cost lab testing. If these clauses exist, identify the payer’s coding requirements.

3. Audit your Chargemaster quarterlyCapture and code and all charges associated with high-cost pharmaceuticals and lab tests. Ensure that all the appropriate codes are identified and entered into the Chargemaster with the correct pricing.

4. Develop a managed care contract strategy. Negotiate special provisions in your managed care contracts for high-cost pharmaceuticals, orphan drugs and lab testing. Four types of contract-provisional clauses that apply to most high-cost drugs and lab tests include: trailer claims, carve-outs, cost outliers, and stop-loss thresholds.

5. Map your managed care reimbursements to actual payments. To ensure manage care contracted reimbursement, compare actual payments to specified agreement terms.

Many times managed care payments miss the high-cost drug payments and this is a lost revenue opportunity for hospitals. Click To Tweet

Call VIE Healthcare to schedule a call to learn how your hospital can implement best practices in high-cost drug revenue optimization at 1-888-484-3332 ext 501 or email me at lmiller@viehealthcare.com.

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© VIE Healthcare® Consulting - All Rights Reserved || Policies
VIE Healthcare is approved under the Small Business Set-Aside Act and Minority and Women Certification Program

© VIE Healthcare® Consulting
All Rights Reserved || Policies

VIE Healthcare is approved under the Small Business Set-Aside Act and Minority and Women Certification Program

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Maximize your hospital’s profitability and enhance patient care.

Subscribe to The Cost Advantage of Healthcare Leaders and receive this special report with 15 Innovative Cost Savings Strategies

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