Hospital & Practice Review Services

Reviews and Education:
Business Dynamics Limited specializes in spine practice reviews, assessment, and education, which may be performed either on-site or off-site to accommodate practices that range in size from the solo practitioner to large groups. Reviews are targeted for surgical service claims and/or spinal injection procedure claims for physician and physician assistant providers. These protocols, designed to evaluate and aid the practice in achieving the maximum reimbursement for services rendered, include the following key reporting components:

CLAIMS REVIEW:

• Coding and documentation issues (accuracy & compliance)
• Timeliness of claims submission
• Appropriate receipt of reimbursement
• Review collection method
• Denial and appeal process

Claims Review services are provided only on an off-site basis. Business Dynamics Limited staff will review a random selection of twenty (20) claims. Copies of all claim forms, operative reports/chart documentation, EOBs, and collection notes are sent to the BDL home office in Mineola, NY. This allows for the review to be done outside of the practice so as not to interrupt the daily workflow of staff and providers. The Claims Review provides valuable insight into the coding, billing, and collections processes specific to spine surgeries or interventional procedures. A detailed written report is generated, containing comments, recommendations, and analyses of Business Dynamics Limited's findings during the review.

COMPREHENSIVE BILLING OFFICE ASSESSMENT:
(Includes the following components, in addition to those in the CLAIMS REVIEW)

• Insurance dependency
• Collections protocols
• Denial management
• Appeal strategies
• Accounts Receivable management

On-Site:
Our team (comprised of Certified Coders, MBAs, Spine Billing Specialists, Practice Managers and support staff) perform the comprehensive review on-site at the practice. A minimum three-day visit to the practice is required in order to perform this review. The client will be charged for all expenses incurred by BDL staff for travel and any other expenses incurred during the on-site stay. Depending upon the size of the practice, and the scope of the review requested, one (1) or two (2) BDL representatives are required for an on-site practice claims review. The review includes the following components:

• Original claims, medical records, reports, EOBs, and other documentation are examined. Education is provided for the staff in the form of immediate feedback and training during the review process. At the completion of the review a brief exit summary is conducted.
• Following the site visit, a detailed report is generated containing comments, recommendations, and analyses of Business Dynamics Limited's findings during the review.

Off-Site:
Off-site Reviews offer a more flexible and cost effective option to the spine practice. Copies of all documentation, billing information and reports are sent to Business Dynamics Limited. This allows for the review to be done outside of the practice so as not to interrupt the daily workflow of staff and providers. Our same highly qualified team completes the analysis from information submitted to our corporate headquarters. The practice may elect off-site Comprehensive Reviews without the added travel costs associated with on-site Reviews. The review includes the following components:

• Copies of claims, medical records, reports, EOBs, and other documentation are examined and analyzed. Education is provided to the practice in the form of written feedback and training outlined in the written report findings. We will communicate with staff via telephone and e-mail when necessary. At the completion of the review a telephone exit summary may be scheduled to discuss key findings in addition to the written report that is provided.
• A detailed report is generated containing comments, recommendations, and analyses of Business Dynamics Limited's findings during the review.