We Simplify and Maximize
Your Healthcare Operations.
Providing Solutions to Healthcare Providers…
Macman Management Healthcare Services’ mission is to provide premier solutions and services to non-profit and private healthcare organizations. We are committed to supporting our client’s vision by delivering cost effective, ethical, reliable, and high quality healthcare solutions of strategic value to our clients.
In the very challenging and complex field of healthcare, our company offers clients ways to simplify and maximize their business. We at Macman Management Healthcare Services have over 35 years of experience in the healthcare industry.
What We Do
Revenue Cycle Management services involve focusing on maximizing maintenance and growth. To do that one must start at the source of financial gain in the medical office; claims. The patient calls for an appointment, staff checks eligibility and schedules the patient, patient registers at the office and verifies personal information, staff collects any payments required, clinician/provider sees the patient, visit is completed and documentation is finished, information is reviewed and processed, clean claim sent to insurance company (payor), payor processes claim and sends back either a payment or denial, staff then posts payments or does denial management to reprocess the claim and get paid. This is universal for Community Health Centers and Private Providers alike!
Operations Management refers to the administration of business practices to create the highest level of efficiency possible within an organization. In terms of healthcare services, that translates into working closely throughout a practice’s revenue cycle and providing skills and services to all the areas to promote and establish efficiency.
During our Billing Audits we review the entire life cycle of the claim in the billing system based on the appropriate rules and regulations. The analysis will determine all levels of audit eligibility, charges captured, provider, location, submission, and adjudication of the claim. All types of visits will be captured including billable, non-billable, and additional enabling services that are being tracked in the billing system.
Quality Improvement (QI) consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of patient groups. Quality in health care can be defined as a direct correlation between the level of improved health services and the desired health outcomes of individuals and populations. With the increased focus towards quality care and public reporting of provider level data, our staff can provide exceptional expertise for you to meet State and Federal Guidelines, including becoming Certified Patient Centered Medical Home and achieving Meaningful Use.
Provider enrollment and re-credentialing functions can be a confusing and lengthy process for physicians, non-physicians practitioners, and other qualified providers especially when completing the credentialing and/or enrollment process with CMS, Medicare, Medi-Cal and Managed Care Plans. MMHCS offers qualified providers with the hassle free services of processing and managing your provider’s enrollment and/or completion of re-credentialing applications. As the Healthcare Reform continues to change, healthcare plans are also changing their own requirements.
MMHCS recognizes that Peer Review is a requirement for FQHC as a part of Quality Assurance/performance improvement plan which should be completed once a year. It is a measure of quality of care rendered by providers. Several aspects of Peer review covered in our model of service include medical records review, patient complaints and grievances, adverse clinical outcomes and potential adverse events at inpatient or outpatient level. Peer review data is highly recommended as part of a provider’s performance evaluation and credentialing.