Healthcare is serious business, and the repercussions of deficiencies in medical documentation can be considerable.
These days medical documentation encompasses so much more than transcribing patient notes. Due to recent laws and regulations, Electronic Health Records (EHR) is just one facet. For providers, institutions, businesses and social media there are many requirements for accurate written documents.
Here are some examples:
- The massive implementation of ICD-10 Diagnosis Codes will require a revamp of the vast majority of procedural manuals in the US.
- Medicaid expansion programs in many states will require updates to existing state and health plan manuals.
- The ACA is initiating changes to provider billing, claims processing, etc.
- New programs and procedures need to be documented and developed as training materials
Clinical documentation improvement (CDI) may become a survival tactic for hospitals, doctor groups, insurance companies and health plans.
Insurance Provider Manuals are the primary information source for coverage policies, rates and billing procedures and need to be updated on an ongoing basis. States and health plans also will be kept very busy rewriting their manuals and web pages.
At TCS, our writers/consultants are well-versed in the healthcare field and are ready to attack your healthcare provider documentation needs.
This particular speciality is headed up at TCS by Paula Thomas, herself a 15 year veteran in the industry.
Her background includes both IT system and health plan implementations, and ongoing business process operations and management. She’s a resourceful leader, with significant expertise in Medicaid and Medicare Managed Care solutions focused on all aspects of health plan, and care management operations, health plan growth, and new market expansions.
Her career at United Health Care enabled her to become highly effective at working with State and regulatory agencies and personnel, ensuring that commitments, business objectives and deliverables exceeded expected results. At a local health plan level, Paula has led teams in development of Medicaid Member and Provider manuals based on the requirements of multiple states. She also created Medicare training materials for various educational needs
Paula is also a Partner at our sister company, 800Weeks – a growing health care and benefits consultancy helping individuals and small businesses nation-wide navigate the increasingly complex world of health insurance and retirement benefits. www.800weeks.com
In addition to Paula, our Health Documentation staff is further augmented by Principal Consultant Dawn Quesada.
Ms. Quesada’s 20 years of experience, which includes 10 years as a Certified Professional Coder, involves health plan operations, rate structures and payment methodologies, public speaking, provider relations, contract administration, process improvement, government relations and database development.
Employed by a leading Fortune 500 health care company and the Texas Children’s Health Plan, the nation’s first pediatric HMO dedicated to serving moms and babies in the Texas Medicaid program, Dawn’s experience included claims, call center, enrollment, and provider network operations. She analyzed and interpreted state contracts to ensure operational and regulatory compliance. She also managed a team of twelve (12) employees, and was responsible for claims payment compliance.
Now independent and managing her own practice, Dawn lends her considerable experience to 800 Weeks as our lead consultant for health care and medical practice content creation.
Contact us today for a quote on your healthcare & medical provider related documentation needs.