Archive for New Member Spotlight

New Member Spotlight: Quality Care ER

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 26th, to hear directly about the issues and updates in the Quality, Coding and Documentation Committee.

New Member Spotlight: Phoenix Coding and Consulting

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 101st 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.

 

New Member Spotlight: Concord Medical Group

Concord Medical Group is a physician-owned and -operated organization founded by Dr. Kyle Sheets in 2001. The group’s beginning focused on supporting rural hospitals in Texas. Concord has grown over the years and, in addition to emergency medicine, the group offers hospitalist and radiology specialties. Concord is now in ten states, managing over 80 programs with over 1,300 providers. Emergency medicine continues to be the group’s main focus. For more information on the Concord Medical Group, click here.

Excerpts from a conversation with Steve Kearney, Executive Vice President, and Chief Financial Officer

Concord Medical Group prides itself on its bespoke approach. There is no cookie-cutter approach as they focus carefully on meeting the needs of each of their clients. This includes providing the highest-quality patient care; supporting their physicians and other professionals with scheduling, training, and recruitment; and ensuring the effectiveness of their programs. Mr. Kearney joined Concord Medical Group over four years ago after managing two other emergency medicine groups. He comes with years of experience in developing and improving accounting, financial reporting, and financial planning & analysis as well as supporting financial systems that support higher levels of performance.

Mr. Kearney was familiar with EDPMA since he had worked in emergency medicine for years and had attended several Solutions Summit conferences. Steve recommended joining EDPMA, in part, due to the productive Solutions Summit conferences indicating a level of professionalism within the association. Steve said, “the conference has always been so well run and the programming informative and timely.” Mr. Kearney believes EDPMA’s member mix of physician groups and suppliers is useful. He said, “if we were looking for a supplier, of course, we would look at who is a member of EDPMA as a starting point.”

Mr. Kearney sees some of the current challenges in emergency medicine related to the implementation of the No Surprises Act and issues that regularly come up with payers. Mr. Kearney emphasized all the resources available to EDPMA members including the Toolboxes which provide detailed information on legislative and regulatory matters at the state and federal levels, including templates for taking action. And Steve wants to be sure his senior-level team is exposed to all these resources as they provide hands-on, practical and useable information. Steve also highlighted that being a member of EDPMA provides a collaborative approach to identifying and solving issues in emergency medicine. He knows the “go-it-alone” approach usually is not successful but working with so many knowledgeable colleagues provides the best avenue for meeting the challenges in emergency medicine and being successful.

Mr. Kearney and Dr. Sheets will be attending the 2021 Solutions Summit (September 26-29 in Fort Worth, TX). They look forward to seeing their colleagues, hearing the latest updates on business issues, legislation, and regulatory updates, and enjoying the great networking events. Steve has joined the Practice Management Committee and is encouraging his senior management team to join other EDPMA Committees such as Federal Health Policy, State Regulatory and Insurance, and the Quality, Coding, and Documentation committees.

EDPMA New Member Spotlight: Alteon Health

EDPMA New Member Spotlight: Alteon Health

Alteon Health partners with hospitals to deliver the highest-quality patient care. The company works to empower physicians and staff to employ innovative and adaptable care-delivery models. Alteon Health prides itself on strengthening the skills of their team members through mentorship, education, and professional development. For more information on Alteon Health, click here.

Excerpts from a conversation with Chris Greenwood, Vice President, Growth and Integrations

Mr. Greenwood joined Alteon Health 2 1/2 years ago after several years in various business areas in healthcare including managed care contracting, EHR development and implementation, and onboarding and integration of new business through organic growth, mergers and acquisitions. Alteon Health was formed in 2017 from the merger of two long-standing physician staffing companies – Emergency Medicine Associates (EMA) of Maryland and Island Medical Management of New York. Together, the company has over 40 years of experience in emergency medicine.

Chris spearheaded the effort to have Alteon Health become an EDPMA member because of several conversations he had with EDPMA members and a review of EDPMA’s advocacy work, particularly at the Federal level. Mr. Greenwood said, “Alteon Health wants to become part of EDPMA’s collaborative team, raise our voice on issues of importance to emergency medicine and be a thought leader.” Chris understands the importance of being involved and informed on Federal legislation and the impact of various laws and policies on their business model and physicians. Mr. Greenwood highlights that the pressures of the Coronavirus pandemic have contributed to new challenges for emergency medicine including new staffing issues and potentially lower volumes continuing. Chris believes that EDPMA’s collaborative approach helps all groups and businesses in emergency medicine reach better results than each company can attain acting individually.

Other challenges Mr. Greenwood sees in emergency medicine include staying informed on CMS’s activities and being part of EDPMA’s collective input into the decision-making process. Chris appreciates EDPMA’s efforts in working on the issues related to the implementation of the No Surprises Act (NSA) and keeping the membership informed through the monthly Advocacy Newsletter. Chris appreciates that EDPMA works proactively on various legislative and regulatory issues, such as Surprise Medical Billing and problematic down-coding at both the Federal and state levels. He also commented that he is looking forward to the Wednesday morning session at the upcoming Solutions Summit (scheduled for September 26-29) focusing on key legislative issues.

Chris has joined EDPMA’s Federal Health Policy Committee (FHPC) and the State Regulatory and Insurance Committee (SRIC) and is encouraging his team members to join others, in particular, the Quality, Coding, and Documentation Committee (QCDC) and the Practice Management Committee (PMC). Chris understands it’s important to hear the discussion of the issues and viewpoints while being part of the group that develops solutions and strategies. Mr. Greenwood looks forward to seeing many colleagues at EDPMA’s 2021 Solutions Summit on September 26-29 in Fort Worth, Texas.

EDPMA New Member Spotlight: NYM Health

Nym Health has been in business for about three years and is headquartered in Boston, Massachusetts.  Nym Health transforms revenue cycle management with direct-to-billing autonomous coding that reduces denials and operational expenses, accelerates payment cycles and maximizes audit-readiness. For more information on Nym Health, please click here.

Excerpts from a conversation with Amihai Neiderman, Chief Executive Officer

Mr. Neiderman has a BA in Math and Computer Sciences, served as an officer for over 10 years in the Israeli Defense Force’s cybersecurity unit, and volunteered as an EMT for more than 8 years. Medicine also runs in the family, as his wife is an ENT surgeon at a large hospital. Amihai and his partner, CTO Adam Rimon, founded Nym Health in 2018.

Nym Health employs physicians, teamed alongside programmers and computational linguists. In addition, every employee at Nym completes a certified medical coding course. This strategy supports Nym’s goal of understanding what the physician is doing, placing themselves alongside the physician in the emergency department with each individual patient.

Nym’s autonomous coding technology, applied in a real-world environment, enables Nym to capture the nuances of medical coding. This knowledge in turn assists their clients, as Nym better understands how coding then drives reimbursement. Nym is well aware that for the practicing emergency medicine physician, the challenge of working in a busy emergency department is characterized by an irregular schedule, hectic events followed by down times, and different volume flows. High-acuity patients need a physician’s full focus, and high-quality patient care is their top concern, with medical coding not being a main priority for the physician.

Amihai was introduced to EDPMA by a colleague in emergency medicine and was planning on speaking at the 2020 Solutions Summit (before it was cancelled due to the COVID pandemic). Instead, Mr. Neiderman chose to join EDPMA to ensure Nym was able to hear first-hand about key issues and challenges in emergency medicine, learning about the legislative and regulatory priorities EDPMA members are focused on at both the State and Federal level.

By becoming a member, Nym Health’s employees receive all of EDPMA’s information, including the monthly Membership and Advocacy newsletters, weekly ED newsletter and action and news alerts. According to Amihai, “We are always looking to improve what we’re doing and proactively help the industry, so joining EDPMA made a lot of sense.”

In addition, Nym’s Chief Medical Information Officer has joined the Quality, Coding and Documentation Committee (QCDC) to learn what members see is happening with problematic downcoding, and be a part of the discussion to come up with solutions.

Amihai and his team will be attending and exhibiting at the 2021 Solutions Summit (September 26-29, Fort Worth, TX.) As this will be Nym Health’s first Solutions Summit, he is looking forward to meeting many of the members, hearing the educational sessions and enjoying the many networking opportunities.

New Member Spotlight: Carson-Tahoe Emergency Physicians

Carson-Tahoe Emergency Physicians, Carson City, NV, has been in practice for over 35 years. In 2020, the group expanded to 26 emergency bays and has six FastTrack emergency bays. And Carson Tahoe Health is the first and only organization in Nevada to receive the esteemed Lantern Award from the Emergency Nurses Association. The ENA recognizes just 25 emergency departments worldwide that exemplify exceptional practice and innovative performance. Here’s more information on The Lantern Award and for information on Carson Tahoe Emergency Physicians, please click here.

Excerpts from a conversation with David Strull, MD, Chief Business Officer
Dr. Strull began his career with Carson-Tahoe Emergency Physicians (CTEP) and worked clinically for over 33 years. He continues to lead the business side of the group. Dr. Strull said 2020 was the most challenging year he has seen given the Coronavirus pandemic. In addition to the clinical challenges with the introduction of a new disease into the community, David said, the personal risk to doctors, nurses and the whole team combined with the sudden decline in patient volume, particularly in March-April, added up to an unusual and difficult year. Dr. Strull points out that most of the volume returned later in the year but it still has not returned fully to pre-COVID levels.

Dr. Strull was aware of EDPMA but it was the COVID-focused information that pushed him to join. EDPMA provided detailed information about COVID relief packages and advocated for emergency medicine throughout 2020. (See 2020 EDPMA Advocacy Successes.) Dr. Strull realized that he needed to better understand the various Federal programs and take advantage of the webinars that helped clarify the Paycheck Protection Act, the CARES Act and other programs, and he was pleased that EDPMA was a leader in advocating for emergency medicine physicians and participating in likeminded coalitions. In addition to all of the Coronavirus-related information, Dr. Strull discussed the critical importance of the Surprise Medical Billing (SMB) Act and the need to get involved in the operationalizing of this legislation. Dr. Strull is aware that this will be a top priority for EDPMA in 2021. And David points out that Nevada has its own Surprise Medical Billing bill. Thus, how the state and Federal bills will work in a real-world environment is of critical importance.

Dr. Strull also discussed that one key challenge in emergency medicine is that cognitive services are undervalued as compared with procedural services. David said, “emergency medicine physicians are often reimbursed at a lower level because they did not perform a procedure, such as surgery, but instead, provided an analysis and recommendation to treat the individual.” Dr. Strull believes this imbalance in the House of Medicine should be addressed. David also commented on the important work that EDPMA does in fighting commercial payers who try to limit reimbursements without reasonable justification. Dr. Strull appreciates the work that EDPMA does to rectify these situations. While David has not yet had time to join an EDPMA Committee, he plans to do so in 2021 so he can be directly involved in the idea generation and action plans for this year.

New Member Spotlight: Premium Asset Recovery Corporation (PARC)

Chris Conway started Premium Asset Recovery Corp. (PARC) in 1997. The firm’s mission is to provide smart, profitable solutions with the highest level of customer service while respecting and maintaining excellent patient relationships. The firm focuses exclusively on healthcare debt buying and offers services nationwide. For more information on PARC, please click HERE.

Excerpts from a conversation with Chris Conway, CEO and Founder

Chris Conway has spent over 31 years in collections and receivables management, including 10 years as General Manager of a hospital-owned collection agency. Chris understands the intricacies involved with increasing recoveries while maintaining a high satisfaction level with senior executives, physicians and patients. Chris has run several private companies and sold one company to a publicly traded organization. Chris’s company provides liquidity at any stage in the accounts receivables lifecycle while primarily focusing on late-stage receivables.

Mr. Conway became involved in EDPMA when his company exhibited at two Solutions Summit conferences. He found the conference and exhibit hall attracted many senior level people in emergency medicine. Chris said the networking events with EDPMA, as compared with other associations in healthcare, were always topflight. Mr. Conway also attended several conference sessions (as exhibitors are welcome to attend the conference) and he found the content to be relevant, timely and focused on the needs of the ED practice. Plus, as the conference is a reasonable size, it’s easy to find people and continue important conversations.

Mr. Conway highlighted that EDPMA’s focus on state and federal advocacy and, in particular, taking into account the needs of independent practices, is a key reason why PARC became a member. Chris said that EDPMA “gives a voice and a presence to the small and mid-sized independent practices that he doesn’t see elsewhere.” Chris said that EDPMA “creates a coalition of like-minded professionals in advocacy.” He has found many of his clients are EDPMA members and that was another reason his company joined. He realized the importance of being “in the know” about what is happening in advocacy and what his clients (and prospects) are focusing on regarding the challenges faced on the legislative and regulatory front at both the state and federal levels. Mr. Conway said that “one of the challenges in emergency medicine is the increasing need for self-pay and the decrease in reimbursement.” He finds this troubling and is concerned about the long-term affordability and quality of healthcare.

Mr. Conway plans to exhibit again at the upcoming Solutions Summit from September 26-29 in Fort Worth, TX. He looks forward to reconnecting, in person, with colleagues, clients and prospects. And he knows the conference sessions will be timely and informative.

New Member Spotlight: CompMed

CompMed is a medical billing and practice management company founded in 1993. Mr. Stearns started the company with six employees focusing on one medical specialty. Almost 30 years later, it has over 200 employees, operates in almost every state and supports over 25 specialties. CompMed focuses on these core principles: hard work; providing quality education and training for employees, and maintaining cutting-edge technology and ongoing, face-to-face client engagement and communications. All of CompMed’s operations are based in the U.S. For more information, please click HERE.

Excerpts from a conversation with Mike Stearns, CPA, MBA, President and Owner

Mike Stearns has worked in healthcare for over 30 years. Early on, he worked for an anesthesiology group practice and quickly saw the opportunity for a billing and practice management firm working as a separate entity supporting independent group practices. Over time, Mike expanded the firm from one specialty to many, adding emergency medicine, hospitalists, geriatrician groups and more.

Mr. Stearns heard about EDPMA through a member at a healthcare event. He then took an interest in learning about the association and spent some time doing research. Mike decided to have his company join EPDMA last year and encouraged many of his employees, particularly the coding staff, to add their names (and emails) to EDPMA’s distribution list so they receive EDPMA’s weekly ED newsletter, monthly Advocacy and Membership newsletters, News and Action Alerts directly. (Direct employees are welcome to receive EDPMA’s benefits directly, there is no need to join separately.) This information enables many people in the company to stay on top of what is happening in emergency medicine and use this knowledge to help guide their clients.

Mr. Stearns is especially interested in the legislative and regulatory issues impacting emergency medicine at the state and federal levels. He knows that the providers expect them to know what is happening with current legislation, reimbursement changes and other issues. Mike said, “EDPMA is the best at providing information on key legislative and regulatory issues on emergency medicine.” And further, “EDPMA is unique in its ability to stay on top of the issues, to explain the issues clearly and provide tools to take action.” Mike said EDPMA’s focus on emergency medicine legislation and regulation was a key reason why his company joined the association.

Another important benefit in being a EDPMA member, according to Mr. Stearns, “is the networking opportunities, the chance to talk to potential clients, experts in the field and learn what is top-of-mind in emergency medicine.” As the owner and President, Mike enjoys talking with his clients, is accessible and wants to learn about their needs and concerns. While he looks forward to getting back to in-person events, he also said that the EDPMA webinars have provided information on “hot topics” and has found these to be a productive use of his time.