Quality Care ER is a Texas-based company that owns and operates two freestanding emergency centers: one in Paris, Texas, and a second just opened in Greenville, Texas. Quality Care ER’s mission is focused on providing high-quality care in rural areas, expanding healthcare services to those with limited access, and serving the local communities. For more information on Quality Care ER click HERE.

Excerpts from a conversation with Byron Prince, Executive Vice President

Byron Prince is an ER nurse with years of experience in emergency medicine management. Mr. Prince joined Quality Care ER almost two years ago and oversees all areas of their business operations. Byron has worked as an ER nurse in a cardiac ER and the main ER. As he moved into managing and the business side, he also worked as a divisional director in a major health system for the emergency department and several outpatient departments. Mr. Prince helped that team expand their services and skills into a sustainable, scalable model. Byron joined Quality Care ER to bring these skills and capabilities to this freestanding emergency company and to support its mission of providing high-quality care with a grassroots and community-driven focus in rural communities.

Mr. Prince decided to join EDPMA based on the recommendation of a current member. He was especially drawn to the collaborative style and networking of EDPMA members in sharing best practices and ideas. Byron highlighted that he sees the dynamism and fast-moving environment in EM not only in coding and documentation but also in communication, billing, building relationships, and networking. For Byron and his team, he’s aware that it’s critical to have trusted information sources and to stay up-to-date and knowledgeable about legislation and regulatory matters impacting EM. Plus, he encourages his department leaders to get involved and stay close to the information on EM because of its dynamic and fast-moving nature.

Byron is particularly interested in coding and documentation as every day he sees how these issues drive and directly impact billing and insurance reimbursement. Byron wants his team to understand how coding and documentation impact billing and reimbursement and understand the whole process. Mr. Prince highlights that EDPMA’s collaborative approach helps support gaining this important information about coding and documentation processes. In addition, the relationships and networking within EDPMA membership help connect colleagues who are willing to give feedback on how to approach various situations. These relationships are especially important for a young and growing company. Byron points out that he expects payers to treat similar care decisions fairly. With his company’s membership in EDPMA, he can gain insight into whether various coding and documentation of health situations are being managed fairly by payer companies.

Mr. Prince and his colleague, Lisa Parker, Revenue Cycle Director, plan on attending EDPMA’s 2021 Solutions Summit conference on September 26-29 at the Omni Hotel in Fort Worth, Texas. Byron said he “looks forward to connecting with colleagues and meeting many new EM professionals as well.” Byron plans to attend Committee Day on Sunday, September 26^th, to hear directly about the issues and updates in the Quality, Coding and Documentation Committee.

Phoenix Coding and Consulting is a Texas-based firm specializing in medical coding and consulting for physician groups, urgent care, FSECs and hospital-based emergency departments. The company prides itself on delivering its services with accuracy, integrity, and in a timely manner.  Phoenix achieves this by working in tandem with its business partners to provide the best experience possible for clients. For more information on Phoenix Coding and Consulting, click here.

Excerpts from a conversation with Terri Tamez, CPC, CEO and Matt Tamez, CPB, B.S., COO

Terri and Matt Tamez started Phoenix Coding and Consulting in 2016 with over 25 years of experience in coding, technology and business process management. Terri has over 20 years of experience in emergency medicine coding and has worked for large emergency medicine RCM companies. Terri is considered by clients and peers as a subject matter expert in emergency medicine coding and frequently provides audit and consulting services to clients with RCM challenges. Matt has over 20 years of experience in data center management, information technology, risk and compliance and business process management.  Matt started his career as a Combat Medic with the 101^st Airborne Division and volunteering as an EMT with his local fire department. They combine their skills along with their customer-service-first attitude to bring a wealth of knowledge to their clients. Their goal is to drive a positive patient experience along with client satisfaction which ultimately leads directly to better levels of reimbursement. Terri and Matt believe that the highest levels of reimbursement are driven by a partnership between Phoenix and clients and providing consistent education to their teams.

Both Terri and Matt have been to several EDPMA Solutions Summit conferences and have many colleagues in the emergency medicine field. They decided to join EDPMA as they view educating their clients as a key responsibility which provides a competitive advantage. Matt said, “that the educational and networking opportunities at the Solutions Summit are a valuable use of his time.” And Terri commented that “the educational events, the webinars and workshops, all help keep them informed and knowledgeable about the key issues impacting emergency medicine.” Phoenix stays focused on meeting their client needs by updating their team on what is happening in emergency medicine reimbursement and keeping their clients and business partners educated on these topics.

Mr. Tamez highlighted that many of the key issues in emergency medicine relate directly to coding as insurance companies are working to downcode various procedures. Being a member of EDPMA keeps Phoenix informed as to the strategy and plans for combatting these problems. And, as Matt points out, “being part of the strategy discussion and the solution is a great part of EDPMA membership.” The efforts in working with colleagues and getting ahead of bad payer policies or finding ways to change or minimize these bad payer policies provides a real return on their investment in EDPMA.  It also directly supports Phoenix’s business strategy of being an effective business and solutions partner.

Matt and Terri will be attending the 2021 Solutions Summit (September 26-29 in Fort Worth, TX). Matt recently joined the Practice Management Committee and Terri joined the Quality, Coding and Documentation Committee. They are planning to attend Committee Day on Sunday, September 25, to hear first-hand about the issues under discussion and participate in these sessions.