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apogee consulting group

Presentation Overview. Company ProfileApogee's Products

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apogee consulting group

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    1. Apogee Consulting Group Presented By: Russell Mancini & Frank Nitto

    3. Company Profile In Business Since 1996 Headquarters -Houston, Texas 18 Employees Managed Care and Medicare Compliance Review Services

    4. APOGEE’S PRODUCTS & SERVICES

    6. Managed Care Solutions

    7. Are You at Risk? Volume of Contracts > 15% Complex Contracts (Cardiovascular, NICU, Trauma, Burn, etc.) Contracts with Multiple Per Diems and Case Rates in Combination Contracts with Outlier Clauses

    8. MPR Project Objectives Identify and Recover Cash Actions, Procedures, Integration Training to Minimize Revenue “Leakage” Provide Information and Strategies in Future Contract Negotiations

    9. Identify and Recover Cash

    10. #1 Identify and Recover Cash Survey Hospital Payment Policies and Procedures Review Contracts to Identify Key Areas at Risk Compare Contracts to Financial Data Identify Underpayments Follow-up with Payer to Recover Cash Provide Monthly Reports Identifying Source of Underpayments

    11. Cash Identified & Collected

    12. Type of Error Summary

    13. Top 10 Insurance Companies

    14. $ Recovered Per Type of Error

    15. Needle in a Haystack

    16. Minimize Future Cash Leakage

    17. # 2 Minimize Future Cash Leakage 1. Identify Problem Sources 2. Recommend and/or Implement Solutions 3. Train Staff to Identify and Resolve Incorrect Payments 4. Train Staff to Negotiate Higher Reimbursements

    18. Future Contract Negotiations

    19. #3 Future Contract Negotiations 1. Analyze Historical Reimbursement Activity 2. Recommend Changes to Contract Language 3. Suggest Commonly Used Contract Provisions and Rate Structures 4. Provide General Market Comparison of Contract Rates & Structures Providing Information to Negotiate Higher Reimbursement

    20. Impact on Payer Relations No Impact on Future Negotiations

    21. Client Interface

    22. Client Interface How Does Apogee Minimize Hospital Staff Time and Still Achieve Project Objectives?

    24. Client Interface Feasibility Study (1-5 days) Audit (4-6 months) Project Conclusions and Recommendations

    25. Apogee Project Team

    26. Apogee Project Team Professional, Experienced, Diverse Accountants, Financial Analysts, MBAs RNs, Case Managers and Utilization Review Information System Specialists Contract (Legal) Specialists

    27. Project Overview

    28. Project Overview

    29. Project Fee Options Contingency Hourly Rate with Incentives

    30. Apogee Consulting Group Healthcare Professionals Providing Solutions In Managed Care

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