A Dynamic Approach to Your Needs
GCS offers a complete spectrum of services for both the small independent practice to large integrated health systems. We’re a progressive, forward-thinking company and our perseverance of innovation in technology reflects this. GCS provides visionary products and strategies focused on sustainability and ensuring the work we do for you today, will continue to pave the way for tomorrow.
Compliance Audits
GCS has over two decades of expertise performing compliance audits for professional services, aligning medical experience with regulatory guidelines. Our seasoned staff has a combined 30+ years of dedicated auditing experience including but not limited to: general and vascular surgery, orthopedic, medical oncology, neurosurgery, pain management, pulmonology, critical care medicine, dermatology, mental health, nephrology, cardiology, pediatric, internal medicine, family practice, OBGYN, and gastroenterology. GCS has invested in the most comprehensive resources for your regulatory needs both on a State and Federal level. Our research experts find the most granular information and guidance to ensure the advice from private and government payors is clear and concise. This combination of experience and resources brings with it our sophisticated reporting process and proprietary metrics, allowing GCS to communicate audit findings both at the executive and physician level.
Coding & Billing Support
Outsourcing short- or long-term coding can provide a means of accurate charge capture with the added benefit of real-time education for physicians and mid-level providers. Billing support may assist in times of short staffing or a leave of absence, removing this burden from the revenue cycle by ensuring timely claims filing and follow-up. Additionally, we have national RVU, APC and DRG payment calculators adjusted for your locality for claim appeals, fee schedule development, or comparative analyses. GCS can also provide coder and biller oversight and training for health systems adding new employees, departments, and specialties. Our credentialed staff is committed to a quick turnaround and accurate outcomes, while reducing the risk of revenue loss during transition periods.
Provider and Coder Education
GCS works to empower our clients, recognizing that auditing and coding support are only pieces of the compliance puzzle. Ongoing education and audit feedback foster a supportive environment to maintain accurate coding, stronger documentation, and long-term successes. Remote or on-site sessions can be customized following any audit and tailored to providers, auditors, or coders. On-demand webinars are also available for clients seeking a refresher course on any coding or compliance topic.
Our team has expert knowledge of the challenges faced with transitioning to an electronic medical record. Our methods help physicians and vendor teams work together to build compliant processes between documentation and billing to sustain better revenue outcomes. Ideally, we assist during operational implementation (go-live) and continue through the critical follow-up time to develop new provider workflows between documentation, validation, and billing functions. Our staff is fluent on multiple platforms and understand the complexities of input and output as it relates to electronic health records. We strive to optimize provider workflow with one-on-one and group feedback to reduce audit risks involving documentation and code assignment.
EMR Implementation
GCS has been instrumental in developing best practice documentation standards for teaching facilities and universities. Our tailored education provides not only the basics, but includes workflow modeling to ensure new providers understand the input and output in EHR’s. We provide a clear roadmap of where documentation might cause vulnerabilities and be subject to government audits. GCS provides interactive training, whether virtual or on site, and focused on preparing residents and students for the challenges faced with documentation and coding in a complex and dynamic environment.
Teaching Facility Training
GCS offers clinical oversight for specialty peer reviews and hospital/clinic mergers and acquisitions. Dr. Stern can offer his expertise in documentation template development for electronic health record implementations and workflow techniques to lower risk, provide efficiencies, and assure appropriate reimbursement. He has an integral role in our compliance department with troubleshooting CMS/RAC payment appeals and denials due to medical necessity. In addition, Dr. Stern can provide ongoing education for any ACO compliance plan.
Medical Directorship
Another aspect of our business is providing large physician-based clinics and hospitals with compliance specific “due diligence” audits for integrations and acquisitions. Although financial performance and credentialing are both key in negotiations, the “compliance” risk of joining with other groups or solo providers can impact the entire organization if not properly assessed. Our risk analysis incorporates historical coding, bell curve comparisons, specialty utilization, documentation practices, past audits, and OIG alerts. Ultimately, administration can use this data for setting compensation, quality incentives, and building “best practice” standards and expectations for new alliances.
ACQUISITION DUE DILIGENCE
Our team has a collective 30 years in providing expert investigative and defense support for local and national law firms. Ranging from small CERT audits and third-party billing issues, to large fraud allegations, we’ve played a significant role in defense cases. Our ability to accurately extrapolate and analyze coding/billing data exceeds expectations of our clients. Our leadership has developed strong working relationships with numerous medical societies and government agencies to provide our clients with the most comprehensive regulatory information available within the industry.