What is the range of services provided by Emergency Consultants and Hospitalist Consultants?
Emergency Consultants and Hospitalist Consultants offer partner hospitals a variety of comprehensive, special services that make our offerings truly unique among companies providing emergency department staffing and management services. Services include:
- Quality Assurance. Our on-going clinical studies ensure consistent, proper clinical outcomes, and our Mistake-Free Medicine program is system-wide and enables our hospital partners to perform well in the Hospital Quality Initiative (“HQI”) mandated by CMS.
- Leader in Patient Satisfaction. Our customer-service training program, APEX: Advancing the Patient Experience by Achieving Partnership Excellence, ensures continuous improvement in patient satisfaction at all of our partner hospitals. It is provided free only to our clients.
- Operational Efficiency. Our billing company, SymMetric Revenue Solutions, provides the professional fee medical billing and/or coding for Emergency Consultants’-affiliated healthcare systems. Healthcare partners can put SymMetric Revenue Solutions’ specialization in emergency and urgent care medicine to work even further through facility coding for hospital emergency department and clinic services, as well. Through SymMetric Revenue Solutions we are able to generate quarterly practice management reports called ECI Vital Signs that contain invaluable departmental information, including demographics and detailed individual provider information.
- Exceptional Claims History. Our malpractice insurance company, National Guardian Risk Retention Group, provides malpractice insurance coverage only to Emergency Consultants-affiliated providers. By contracting with clinically sound physicians, and through a program of Mistake-Free Medicine, we have achieved a claims rate that is one-third the national average in emergency medicine.
- Superior Documentation System. The ECI QualChart System is a computer-generated template system provided at no cost to our partner healthcare systems, enabling a real savings on the expense of third-party documentation vendors and dictation. Our emergency medicine documentation system has the added benefit of allowing us to capture patient care data for quality management initiatives and risk management analysis.
What is Emergency Consultants' business model?
The business model utilized by Emergency Consultants includes the formation of a limited liability partnership to specifically service your facility. This model allows Emergency Consultants to provide the national expertise in emergency medicine recruiting, staffing, accounting, malpractice, billing and coding etc., and empower your local emergency physician group to service the hospital and community.
What is Emergency Consultants' preferred method of clinical documentation?
The ECI QualChart System is a templated evidence-based documentation tool, and includes the following components:
- Emergency room documentation templates for hundreds of illnesses and injuries
- Over 400 After-Care Patient Instruction Forms available in English and Spanish
- Joint Commission-compliant nursing documentation records
- Evidence-based best practice physician and nursing clinical guidelines
- Extensive educational resources
Emergency Consultants is also experienced in using electronic medical records (EMR) and computerized physician order entry (CPOE). We also have a broad range of experience in many of our other partner hospital emergency departments using EMR- and CPOE-based systems, including MedHost, Meditech, McKesson and IBEX.
Does Emergency Consultants, Inc. perform operational assessments at partner healthcare systems?
Yes. We perform operational assessments, and the data that are provided in Emergency Consultants’ Vital Signs reports are invaluable to this process. Operational assessment of the emergency department is part of the start-up transition process and then continues on an on-going basis. There is no extra charge for this service. Emergency Consultants has enjoyed considerable success in implementing and sustaining efficiencies in areas such as patient satisfaction, reduced walkout rate and turnaround time, and compliance with core clinical indicators.
Can you explain Emergency Consultants' philosophy regarding the role of physician extenders in the emergency department?
Emergency Consultants’ experience with physician extenders has been very positive, from both cost containment as well as patient satisfaction perspectives. Always in concert with the goals and objectives of partner healthcare systems, we use mid-level providers to see “fast track” or minor care patients. This has allowed us to increase our overall hours of emergency department coverage and improve patient throughput times at a reduced cost.
Do hospitals have any control over the hiring of physicians as an Emergency Consultants or Hospitalist Consultants partner?
Acceptance of physician candidates ultimately rests with the healthcare system, the Medical Director, and Regional Director. We will comply with your healthcare system’s policies for credentialing and interviewing. Only physicians who meet all preset criteria and our Primary Source Verification program, which satisfies The Joint Commission standards, will be considered.
Who is Emergency Consultants’ and Hospitalist Consultants’ malpractice insurance carrier?
Medical professional liability insurance is provided by National Guardian Risk Retention Group (“National Guardian”), which has been in continuous operation since January 1, 1989. Coverage is consistent with industry standards and the hospital by-laws.
Do Emergency Consultants and Hospitalist Consultants agree to participate in all insurance and managed care programs in which their partner hospitals participate?
Yes. We will negotiate with all insurance and managed care programs in order to reflect the hospitals' payor agreements, special offers, and charity discounts.
What is the customer service philosophy for Emergency Consultants and Hospitalist Consultants?
We've taken a national leadership role in the development and implementation of state-of-the-art programs to promote patient satisfaction. Our program, APEX: Advancing the Patient Experience by Achieving Partnership Excellence, is designed around the ten most important factors that impact patient satisfaction in the emergency and hospitalist departments. Using these principles, we have achieved outstanding increases in patient satisfaction scores, as well as markedly reduced patient walkouts.
What benchmarking information do Emergency Consultants and Hospitalist Consultants collect?
We produce quarterly management and efficiency reports, called Vital Signs, through which we are able to monitor and report on the productivity and efficiency of the emergency department and each physician individually. Vital Signs is data we will use together to make your department better.
Medical Director Specific
How does the Medical Director interact with the Medical Staff within an Emergency Consultants partnership?
A crucial part of the emergency department leadership is a significant and on-going effort directed towards assessing the needs and requirements of the medical staff. The Medical Director is expected to meet with medical staff leaders, chairmen of clinical departments, and other groups to ensure their goals are incorporated into the objectives for the emergency department. The medical director will also serve on all appropriate committees within the healthcare system (or find an acceptable designee). By this participation, the medical director will be able to appropriately manage the concerns and expectations of the entire medical staff.
What percentage of the Medical Director's time will be devoted to administrative responsibilities within an Emergency Consultants partnership?
Medical Directors typically spend approximately 20 hours per week exclusively involved in the performance of emergency department management and support activities. We believe such services cannot be effectively performed during a concurrent clinical shift and compensates Medical Directors directly for administrative services.
What is Emergency Consultants’ process regarding patient care complaint follow-ups?
The Medical Director reviews, investigates, and appropriately responds to all complaints that arise from patients, medical staff, healthcare system staff, or administration concerning the emergency physician group. Medical Directors discuss each complaint with the physicians involved so that we can all learn from the situation. Emergency Consultants’ goal is to provide effective and fair due process for emergency physicians, patients, and the healthcare system by addressing any concerns or complaints in an open, fair, and forthright manner.
Staffing & Management
How will you work with the hospital staff to ensure a smooth partnership transition?
Prior to the commencement of services, our transition team will meet with healthcare system counterparts to layout expectations of both parties and ensure a smooth transition. Topics such as emergency department recruiting, privileging, credentialing, chart flow, special billing arrangements such as charity care, managed care, and operational issues will be discussed.
Rest assured - you're in good hands! We'll do everything possible to make the experience as seamless as possible. A specific start-up action plan will be developed in conjunction with the client facility and overseen by the Regional Director. This start up plan will deal with everything required to assure a smooth transition to an Hospitalist Consultants-affiliated partnership.
Why should I choose Emergency Consultants over other emergency department staffing and management groups?
Since 1972, Emergency Consultants has specialized in emergency department staffing and the recruitment of top quality and caring physicians - the essential element of every emergency department. We can staff and support your dedicated local group of highly-prepared and qualified emergency physicians.
Can you describe the ownership/management structure within Emergency Consultants and Hospitalist Consultants?
Emergency Consultants and Hospitalist Consultants are physician-led organizations with leadership teams comprised of seasoned physician executives and business professionals. In all facets of business, we maintain a steadfast commitment to putting patients first and the principles of physicians managing physicians.
The executive leadership team includes: James M. Johnson, MD, PhD, co-founder and Chief Executive Officer; Robert M. Williams, MD, DrPH, FACEP, co-founder and Chairman of the Board; Derik K. King, MD, FACEP, President; and Randy Howell, MBA, CMA, Chief Administrative Officer.
The executive leadership team includes: Robert M. Williams, MD, DrPH, FACEP, co-founder and Chairman of the Board; Derik K. King, MD, FACEP, President; Randy Howell, MBA, CMA, Chief Administrative Officer; and Kenneth R. Epstein, MD, FACP, FHM, Chief Medical Officer.
SymMetric Revenue Solutions:
The executive leadership team includes: Randy Howell, Chief Administrative Officer; David A. Thompson, MD, FACEP, Chief Medical Officer and Chief Compliance Officer; John Fraley, President; Derik K. King, MD, FACEP, Vice President; Christopher J. Richter, MD, FACEP, Regional Director.
What process does Emergency Consultants and Hospitalist Consultants use to select and screen physicians?
We first gain a thorough understanding of the needs of your healthcare system through on-site interviews with key individuals in the administration and the medical staff. We screen all candidates prior to credentialing by reviewing the candidate’s professional qualifications, answers to disclosure questions, three peer references, and the results of a personal interview. Through diligent and discerning practitioner credentialing practices, we will assist you in meeting your goals to provide the kind of safe quality care and patient experience that your facility expects and demands.
How are staffing models determined?
Staffing models are unique to the healthcare system and based on emergency department patient volume, patient acuity, and physician-to-patient staffing ratios that are consistent with recommended guidelines for emergency department physician and hospitalist staffing.
What is Emergency Consultants’ goal in finalizing the monthly emergency department physician schedule?
Emergency Consultants works diligently to fully complete all schedules no later than the middle of the preceding month.
Can you describe Emergency Consultants and Hospitalist Consultants’ Quality Management Program and evaluation of physicians' clinical performance?
The foundation of Emergency Consultants’ Quality Management program is the performance of timely and relevant audits, followed by educational interventions to highlight deficiencies and promote compliance with nationally accepted clinical guidelines. ECI’s RAPID (Rapid Analysis of Performance for Improvement of Documentation) Review Process was developed to assess and improve emergency physician evaluation, management, and documentation of selected medical conditions presenting to the emergency department. These conditions correspond with the Centers for Medicare and Medicaid Services (CMS) Hospital Quality Initiatives and Physician Quality Reporting Initiative (PQRI) and The Joint Commission Core Measures.
Does Emergency Consultants promote the use of evidence-based clinical protocols?
Yes. Emergency Consultants’-affiliated hospitals enjoy considerably improved compliance with clinical core indicators through the ECI QualChart System, our computer-based emergency room documentation system that includes a set of over 150 physician documentation templates specific to the patient’s chief complaint. In addition, the system contains over 150 physician and nursing Clinical Guidelines for use by our affiliated providers.
What happens to primary care physician privileges when they stop admitting to the hospital within a Hospitalist Consultants partnership?
This is really up to each individual facility and what their medical staff bylaws state on this particular subject. If there is a hard requirement set forth regarding admissions done in a yearly basis in order to preserve medical staff privileges, most facilities have amended those articles in order to allow physicians using the hospitalist program to maintain their active privileges. Otherwise, PCP’s would be discouraged from utilizing those services.
How are medical staff committees populated if active staff privileges are eliminated within a Hospitalist Consultants partnership?
The active staff privileges would not be eliminated. Medical staff bylaws can be amended to add any additional requirements for membership on specific committees.
Are changes to medical staff by-laws required in order to address these issues within a Hospitalist Consultants partnership?
In most cases, yes (as stated above). Hospitalist Consultants can provide suggestions to you as to how this should be written.
How are unassigned patients connected with primary care follow ups within a Hospitalist Consultants partnership?
This can be done a couple of different ways depending on how these patients are normally distributed. However, in most cases, the patient would be discharged for follow-up with the PCP that was originally slated for taking unassigned call on the day of that particular admission. A schedule would need to be set up for this before the start of a hospitalist program.
I was asked how this would affect after hour clinic calls. I stated it would not affect it and physicians would continue with a call schedule for their clinic call group. Is this correct?
Yes, that is correct. Physicians belonging to a group would be responsible for continuing their normal outpatient call.
Coding & Billing
What is the professional emergency physicians’ billing company utilizes by Emergency Consultants and Hospitalist Consultants?
SymMetric Revenue Solutions is used for all professional emergency physicians’ billing. In the current fiscal year, SymMetric Revenue Solutions will bill more than 1.3 million emergency patients for our affiliated Registered Limited Liability Partnerships. SymMetric Revenue Solutions was created in order to ensure consistent and fully compliant coding of the emergency physician encounter, collection of all legitimate revenues, and outstanding customer service.
What services does SymMetric Revenue Solutions offer?
SymMetric Revenue Solutions can provide a customized package of services for your facility. We offer professional coding and billing for emergency departments and urgent care centers, facility coding, integrated care and hospitalist billings as well as consulting services. Whether your facility needs assistance with coding or requires full coding and billing services, SymMetric Revenue Solutions can provide revenue cycle solutions to meet your needs.
Does SymMetric Revenue Solutions employ certified coders?
Yes. The coding management staff at SymMetric Revenue Solutions holds certifications in Registered Health Information Technician (RHIT), Certified Professional Coders (CPC), Certified Professional Medical Auditor (CPMA), and Certified Medical Reimbursement Specialist (CMRS). Approximately half of the coding staff is also CPC certified.
What is SymMetric Revenue Solutions’ Average Days Outstanding (ADO) to drop claims?
All of SymMetric Revenue Solutions’ executive directors, management and staff are goaled and incentivized with ensuring that patient charts are coded and billed in a timely manner. At the beginning of each year, Average Days Outstanding goals are set for each quarter. SymMetric Revenue Solutions consistently meets or exceeds these goals.
What is SymMetric Revenue Solutions’s average clean claim rate?
By utilizing best practices, analytics and revenue-cycle technologies, SymMetric Revenue Solutions maintains an average clean claim rate of 87%. Our Accounts Receivable Research team works diligently to resolve denials and helps ensure we are receiving the proper reimbursement so that no money is left on the table.
How does SymMetric Revenue Solutions manage the revenue cycle in terms of denials management?
SymMetric Revenue Solutions has designed reporting tools to monitor denial volumes, trend denials over periods of time at a client, payor, and denial code level and flag deviations outside of the norms. Denials are categorized by types and assigned to the department(s) with the process expertise for analysis, identification of root causes, improvement opportunities, and resolution.
What metrics does SymMetric Revenue Solutions use to monitor performance?
SymMetric Revenue Solutions continually monitors performance through various metrics including: random, three tier coding audits, average days outstanding (ADO), InSite reports, Vital Signs reports, the Exception Website, and the Audit for Chart Completion (ACC) Website, and other metrics. InSite and Vital Signs reports provide key performance indicator (KPI) data.
What feedback does SymMetric Revenue Solutions give to providers and administration?
SymMetric Revenue Solutions has several web-based tools that provide direct feedback to providers and administration on documentation and chart delivery. The Exception Website enables the emergency department medical directors to monitor exceptions charts, communicate electronically with AISI, and correct these exceptions. The Audit for Chart Completeness (ACC) website is designed to assist the medical director and providers in finishing certain types of charts that are incomplete such as missing critical care time or laceration length. The Documentation Feedback and Education (DFE) website is an educational tool that provides retrospective feedback to providers so that they can improve their documentation for future patient encounters. Documentation data and key performance indicators are provided to administration in our InSite reports and Vital Signs reports, available on SymMetric Revenue Solutions’ secure ClientPortal.
What type of compliance program does SymMetric Revenue Solutions have in place?
Our Corporate Compliance Program is organized according to the Office of Inspector General’s (OIG) program guidelines and conveys our commitment to the highest principles of corporate conduct. David A. Thompson, MD, FACEP, serves as Chief Medical Officer and Chief Compliance Officer and is responsible for the supervision of all billing and reimbursement activities. Our compliance program is supported by a three-tiered internal auditing process that ensures highly compliant, highly consistent coding and billing. The results of these audits are reviewed weekly by the SymMetric Revenue Solutions Coding Policy and Compliance Committee (CPACC), consisting of the Chief Medical Officer, Director of Coding and the entire Coding Management Team.
What information system is utilized within SymMetric Revenue Solutions?
SymMetric Revenue Solutions’s Galileo system is a fully automated chart processing system with monitoring tools that help us identify problems early on so that they can be resolved quickly. This system uses a combination of applications for entering demographic information and charts, coding and billing patient accounts. These applications include Spyglass, Quillix, Oracle and ClinixMIS, an industry leading Oracle based billing platform. Our technology team can interface with any system in the United States.
When is SymMetric Revenue Solutions available for phone calls and how do you assure short wait times?
The call center is open Monday through Thursday from 9am – 8pm EST, and on Friday from 9am – 4pm EST. Calls are monitored by Collection Operations Management via the Automate Call Distribution activity. A staff of alternate reps from other departments is utilized during high call volume periods to ensure minimum wait times. The average wait time is less than two minutes.
Does SymMetric Revenue Solutions offer credit card payments and internet payment?
Yes. Customer service processes credit cards via an online Merchant Gateway and confirmation is provided to patients immediately. Our patient Physician Billing website offers payments via VISA, Mastercard, American Express, Discover, and PayPal. Patients are also able to update their insurance information on the website.
How does SymMetric Revenue Solutions handle refunds?
We analyze credit balance reports to determine the priority of refunds and also validate. Credit balances are researched, all corresponding documentation is gathered, and a refund check is processed to the appropriate carriers or patient. Depending on the relationship with the client, we either create the refund and invoice, or the client creates the refund.
How are collection agency transfers handled?
A patient receives two statements: a telecollector call and a pre-collection letter. If no payment is received, the account is sent to a collection agency as bad debt.
Do you base your fees on a rate per chart, percentage of collections, or some other method?
Fees are based on a rate per chart. SymMetric Revenue Solutions negotiates a fee with our clients based on patient volume. Through our Process Improvement program and powerful technology, we continually find ways to automate processes and reduce costs, so we can pass our cost savings on to our clients.
What size clients does SymMetric Revenue Solutions, Inc. typically work with?
SymMetric Revenue Solutions, Inc. is a national billing company with the capacity to efficiently and effectively manage your facilities volume. Whether your business is emergency medicine, urgent care, integrated care or a hospitalist program, we can handle the billing regardless of the volume or complexity of your facility.
How is SymMetric Revenue Solutions preparing for ICD-10 implementation?
SymMetric Revenue Solutions, Inc. has adapted the AHIMA approach for the implementation of ICD-10 with SymMetric Revenue Solutions Timeline:
- Phase 1: Implementation plan development and impact assessment
- Phase 2: Implementation preparation
- Phase 3: "Go live" preparation
- Phase 4: Post-implementation follow-up
The AISI ICD-10 plan includes reviewing and assessing all systems for ICD-10 Compliance as well as key impact areas.
Careers – Medical professionals looking for a job
Does Emergency Consultants have a performance-based compensation system for physicians?
Emergency Consultants strongly believes that physicians should be incentivized for being good doctors who practice efficiently. Our wide range of career incentive programs are designed to align the physician practice with the objectives of the healthcare system. Some of the metrics we can use in designing an incentive program can cover emergency department patient satisfaction, CMS Core Measures, RVU productivity, ED throughput metrics, or growing patient volumes.
Do Emergency Consultants and Hospitalist Consultants provide continuing medical education for affiliated physicians?
We are accredited as a provider of continuing medical education credit from the Accreditation Council for Continuing Medical Education (ACCME). Partner physicians can obtain free CME credit via the PartnerPortal. Physicians can access the portal and complete education offerings from anywhere via the internet and will be granted CME credit for reading educational materials that we provide partner physicians on a regular basis.
Do Emergency Consultants and Hospitalist Consultants provide leadership training for Medical Directors?
Yes. We provide formal training for the new Medical Director through the James M. Johnson Physician Leadership Course. This intensive, two-year course begins each fall with a three-day, on-site program in Traverse City, Michigan, and covers all major aspects of physician leadership and development skills.
Does Emergency Consultants require the Medical Director and affiliated physicians to live in the community served?
Our Medical Director and all of our full-time emergency and hospitalist physicians are encouraged to live in the communities in which they serve. Building local bonds among the medical staff, healthcare system employees, and the local community is the hallmark of a successful program.
How do Emergency Consultants and Hospitalist Consultants handle scheduling emergencies?
To achieve flexibility and to plan for contingencies, we retain a number of part-time physicians (and part-time physician extenders, if appropriate) dedicated to your site. Supplementing the full-time physician partners allows for maximum flexibility should an emergency arise. In addition, our emergency and hospitality staffing division is on call at all times (days, nights, weekends, and holidays). If the scheduled physician is unable to cover the shift, appropriate calls are placed to privileged physicians of the facility until a replacement is found.
What type of schedule do physicians normally work?
Physician partners are scheduled for shifts of appropriate length depending on the volume and acuity of the hospital in which they work. Our shift lengths support the safest, most efficient emergency department and hospitalist programs.
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