Presentation on theme: "Overview AmeriVeri CR:"— Presentation transcript:
1 Overview AmeriVeri CR: provides the latest, proprietary, code verification technology;identifies employer savings of 3-8%;operates on performance-based pricing;does not create “noise” in your system or slow down payments;does not change anything – AmeriVeri CR is a secondary process and works with all software systems;provides a choice of free, secure demonstrations:6 month review or 3 month real-time test.
2 Performance-based Pricing AmeriVeri CR fee based on percentage of net savingsNo financial risk of any kindAll appeals handled at no charge by AmeriVeri CRSavings can become a significant new source of revenue for Employers…see the chart
4 Code Verification clinically sound and supported Important NotesCode Verification clinically sound and supported1% provider resubmission rate1/10th of 1% provider appealsAmeriVeri CR provides “turn-key” program andprofessional assistance at every step
5 Uses Application Software Provider (ASP) platform The SystemUses Application Software Provider (ASP) platformInterfaces with all claims administration softwareIdentifies rejections by ANSI reasonUses 1.4 million edits of Current CodeScrubs each claim twice and is constantly reviewed by Coding experts representing over 50 years total experience.
6 Engine Constantly Updated Quarterly updates:HCPCS codes from CMSCPT codes from AMAICD-9-CM codes from DHHSCCI codes from CMSChanging / evolving payer practicesChanging technologiesClinical practice patternsMedical society-driven clinical protocol
7 Secured File Transfer Protocol (SFTP) Data Security / PHISecured File Transfer Protocol (SFTP)128-bit Secured Socket Layer (SSL) encrypted connection (Verisign approved)Meets or exceeds all HIPAA requirementsUtilizes the highest level of security availableSystem housed in a 24-hour security, technical support & climate controlled facility
8 AmeriVeri CR Tech Team Patti Merdian Experience 12/05- present: AmeriVeri CR/Medical Claims Review, LLC President/SVP R&D05/00- 05/09: Bill Dunbar and Associates, LLC Regional Director of Client Services07/99 to 8/00: Indiana University School of Medicine Audit Facilitator/ Billing office manager3/97 to 6/99: JWM Neurology Clinical Operations Manager06/95 through 2/97: New River Valley Ear, Nose, and Throat Associates, PC Office AdministratorCertifications: CPC, CCS—P, CCS, CPC—H, CEMC Certified Professional Coder (CPC), American Academy of Professional Coders Certified Coding Specialist (CCS-P), American Health Information Management Association Certified Coding Specialist- Hospital (CCS), American Health Information Management Association Certified Professional Coder- Hospital (CPC-H), American Academy of Professional Coders Certified Evaluation and Management Coder (CEMC), American Academy of Professional CodersExtensive experience with CPT—4, ICD—9—CM, HCPCS Level II, Chargemaster, Chargesheet, ICD-9-CM database, Explanation of benefit/payment, CMS 1500 and CMS 1450 claim forms, and other unique formsExtensive experience with various billing rules and regulations (e.g., Commercial, Government, Workers’ Compensation), contract adherence, and general practices on the billing side of organizationsMemberships/Affiliations:American Academy of Professional Coders (AAPC)American Health Information Management Association (AHIMA)American Medical Association (AMA)Medical Group Management Association (MGMA)National Association for Occupational Healthcare Providers (NAOHP)Twin County Regional Hospital Foundation Board memberAAPC Local Chapter – Galax, Virginia (Founder, current President)Education: Bachelor of Arts in Life Sciences/ Spanish minor, Indiana State University Master of Science, certificate program, Indiana University (audited for additional college credit) Master of Arts in Education, thesis pended, Virginia Tech
9 AmeriVeri CR Tech Team Steve Reed Summary In-depth experience in strategic planning, business planning, and budgetingEffective operations manager with proven experience in improving financial performance, employee satisfaction, patient satisfaction, quality and patient safetyExperienced managed care negotiator & contractorEffective business developer with in-depth experience in planning, designing, and implementing numerous hospital and healthcare projects, programs and servicesExperienced physician recruiterDirected the development of a $200M master facility plan and hospital replacement projectAssisted in creating a separate joint venture partnership for a hospital-based ambulatory surgery centerFACHE: Fellow, American College of Health Care ExecutivesExperience06/07 to present: AmeriVeri CR/Medical Claims Review Sr. Consultant, Operations03/06 to 05/07: Lant & Associates, Inc. Executive Director02/01 to 02/06: Union Hospital Health Group Chief Operating Officer04/95 to 11/00: Women’s Hospital of Indianapolis President & CEO03/93 to 04/95: Terre Haute Regional Hospital Chief Operating Officer07/89 to 02/93: Charter Medical Administrator11/88 to 07/89: Charter Peachford Hospital Assistant Administrator04/85 to 11/88: Union Hospital Vice President, Professional Services04/84 to 04/85: LaPorte Hospital Director, Human ResourcesEducationBachelors, Business Management Indiana State University, May 1981Masters in Health Administration Indiana University, December 1983Professional ActivitiesFellow, American College of Health Care Executives, Adjunct Faculty, IUPUI, Indiana Wesleyan University & Harrison College, Deacon, First Baptist Church, Past Mentor, IUPUI MHA Program & Suburban Health Organization, Past Member, Southern Indiana Regent’s Advisory Council – ACHE, Past Chairman, Secretary and Board Member , Indiana Health Centers, Past President, Visiting Nurses Association of the Wabash Valley, Past Member, Board of Directors, Indiana Hospital & Health Association (IHHA), Past Chairman, Council on Resource Management – IHHA, Past Member, Board of Directors, Zionsville Rotary Club, Past Chairman, Medical Services Group, Wabash Valley United Way
10 AmeriVeri CR Tech Team Marsha Putt Significant national management experience in customer service from the Corporate automotive sector;Management of dealer and client business relationships for domestic and foreign automotive manufacturers;Developed training initiatives on customer satisfaction and retention;Exceptional ability to develop, facilitate and integrate business programs with varying levels of clients and internal teams.Extensive background in strategy, program management and Six Sigma-based continuous improvement;BS in Industrial Engineering Technology from Purdue University.
11 For More Information Visit us on the internet at www.AmeriVeri.com Or contact:Patti MerdianPresidentJim BaughmanCEOMarsha PuttVP, Client ServicesMartin AmbergerDirector, Marketing Communications