Our services
We seek to provide key services which will drive value for your institution and your patients. Let us provide the services that will allow you to succeed in the mission that matters most: taking great care of your patients.
CDI Education
Professional CDI education of your clinical providers to drive higher quality and accurate reimbursement. Flexible and tailored education of your providers in 1-on-1 and group formats.
Throughput Improvement
Gain the insights of an experienced physician hospital leader in improving patient throughput from admission to discharge. Learn how to implement crucial processes that will increase smooth, efficient care delivery while improving patient satisfaction and safety.
Denials Recovery
Expert management of denials review, peer-to-peer discussions, and written appeals.
Available Services
1. Denials Management & Peer-to-Peer Reviews
Service Description:
Comprehensive review of denied claims to identify opportunities for overturn.
Preparation and execution of peer-to-peer discussions with insurance medical directors to challenge inappropriate denials.
Written appeal assistance with sound rationales that strengthen your facility's ability to recover withheld charges.
Post-review reporting with insights on trends and recommendations for improving future claim approvals.
Client Value:
Recover lost revenue from overturned denials.
Improve claim approval rates and reduce the financial strain of denials.
Key Metrics
80%+ success rate in overturning denials through peer-to-peer reviews.
2. Utilization Management & Medical Necessity Reviews
Service Description:
Daily review of inpatient admissions for medical necessity, appropriate status determination, and length of stay (LOS) optimization.
Collaborate with clinical teams to ensure that care is delivered in the right setting based on medical criteria.
Address inefficient care and unnecessary use of resources through direct physician engagement.
Client Value:
Reduce length of stay and optimize resource use.
Ensure compliance with payer requirements, reducing future denials.
3. Clinical Documentation Improvement (CDI) Education & Optimization
Service Description:
Targeted physician and staff education on improving clinical documentation to reflect severity of illness, risk of mortality, and compliance with payer criteria.
Auditing of current documentation practices to identify gaps that could affect hospital quality metrics and reimbursement rates.
Ongoing training and query management to ensure continuous documentation improvement.
Client Value:
Improve hospital quality scores and reimbursement rates.
Shorten the revenue cycle by facilitating timely completion of charts and coding queries.
4. Post-Acute Care Authorization Acceleration
Service Description:
Facilitation of insurance approvals for skilled nursing facilities (SNF), inpatient rehab, and home health services. Dr. Habeeb is well-acquainted with payer criteria for post-acute levels of care and can help you design protocols and workflows to streamline the discharge planning process.
Collaboration with case management and social work teams to minimize discharge delays related to insurance authorizations. Drive dramatic decreases in excess days related to insurance authorization barriers.
Client Value:
Reduce delays in discharge, improving bed turnover and freeing up resources for new admissions.
Ensure patients receive timely access to appropriate post-acute care settings.
5. Throughput Optimization & Performance Improvement
Service Description:
Analysis of current hospital throughput processes, including bottlenecks and inefficiencies in patient flow from admission to discharge.
Development of tailored strategies to enhance care delivery, reduce wait times, and improve overall operational efficiency.
Regular engagement of medical staff to reduce unnecessary inpatient care and optimize discharge planning.
Client Value:
Reduce hospital bottlenecks and improve patient flow.
Improve patient outcomes by reducing the length of stay and increasing the likelihood of patients returning home or to appropriate post-acute care.
6. Status Determination & Compliance Training
Service Description:
Provide training for ER, hospitalists, and medical staff on correct patient status determinations (inpatient vs. observation).
Auditing and optimization of admission order sets to ensure alignment with payer requirements and minimize post-discharge status downgrades.
Ongoing compliance education to reduce claim rejections and enhance reimbursement accuracy.
Client Value:
Ensure correct status determinations, reducing post-discharge denials.
Improve compliance with evolving payer guidelines, minimizing financial risk.
7. Tailored Consulting & Hospital Audits
Service Description:
Customized consulting engagements based on specific hospital needs, including full audits of utilization management, clinical documentation, and throughput processes.
Recommendations and implementation support to improve operational efficiency, financial performance, and compliance.
Regular follow-up audits and training to ensure sustained improvement.
Client Value:
Comprehensive review and actionable insights tailored to the hospital’s unique challenges.
Continued support to ensure long-term success and sustained improvements.