Prevounce makes it easy to get paid for keeping your patients healthy before they get sick.
Prevounce and Preventative Services
Prevounce focuses on simplifying the provision and management of Preventative Services.
Preventative services are a group of evidence-based screenings, counselings and diagnostics that are recommended by the U.S. Preventative Service Task force.
The US Preventative Task Force is a group of volunteer experts who review research to determine which preventative services should be performed and when.
The Center for Disease Control estimates that if all recommended preventative services were performed in the United States, over 100,000 lives would be saved every year.
As Medicare and other insurers have realized the health benefits (and cost savings) of preventative services, reimbursement and coverage has raised significantly.
A well-managed preventative service program with Prevounce can earn a small practice upwards of $10,000 - $15,000 a month.
Quality Payment programs
In addition to direct revenue, Medicare incorporated many preventative services into their MIPS payment model.
Through MIPS, preventative services are an important tool toward increasing your MIPS modifier and earning a high Medicare Payment Modifier.
What does Prevounce do?
Even with all the benefits of preventative services, they have not fully caught on. Unfortunately, preventative services can be complicated. Each service has specific requirements that can change often, making many doctors avoid them.
Prevounce was created to simplify the entire process so that providers can gain the benefits of preventative services without having to navigate the maze of requirements that often come with them.
Prevounce covers the entire service workflow, from determining patient eligibility, to providing the services, to getting you paid afterwards.
When someone comes into your office with a sore throat, you likely know exactly what to do. You use your experience and education to treat them based on their diagnosis.
Preventative services break this mold since there is not always a clear diagnosis you are treating. Instead, Medicare and other insurance companies have specific eligibility requirements as to when they will pay for each service.
The Prevounce Eligibility Engine takes data from multiple sources to determine patient eligibility and coverage for each preventative service offered. This way, your staff can focus on providing good care, instead of going through checklists to try and guess a patients eligibility.
Preventative services are not always straight forward. Even the same service may have different requirements depending on patient demographics and insurance.
Prevounce simplifies each service using a Smart Service Wizard that provides a step by step form for your staff to follow that is custom generated based on patient demographics, medical history and insurance requirements. No having to look up requirements during a visit - your staff can follow along with Prevounce and be confident that the requirements are met.
Prevounce also has a feature called Patient Outreach that allows your staff to send eligible parts of each service to your patient prior to their visit via email or text message. This can save significant amount of time entering information live with the patient, and makes sure the patient brings all required info prior to the visit.
Medical billing and coding has a reputation for being unecessarily complicated, and the introduction of preventative services has not helped. With no clear billing standards, each insurer had to decide individually how to accept preventative claims.
While we are not powerful enough to declare a billing standard (yet), we have done the next best thing. The Prevounce Smart Billing system automatically generates a recommended superbill after each patient visit taking into account all known coding variations and historical reimbursement data we have.
Just verify the recommended superbill we generate and hand it over to your billing, and you are good to go. On the rare occasion where you do get a denial, the Prevounce billing team is on hand to help your billing team or company.
When a patient has chronic conditions, an effective medical practice will have communication and management of patient conditions between office visits. Medicare and other insurers have taken note of the health benefits of these monthly patient interactions, and now pay for non-face-to-face interaction with your patients on a monthly basis.
Unfortunately, getting paid for Chronic Care Management can be complicated and confusing. Although Medicare has spent the last few years lowering the requirements of Chronic Care Management, there is still a strict set of guidelines that must be followed.
Prevounce was designed to make Chronic Care Management easy, intuitive, efficient and CMS compliant while seamlessly integrating it into your wellness and preventative visit workflow. Prevounce guides your staff through the creation of a care plan, and then logs all the patient time that counts towards CCM. At the end of the month simply generate a CCM billing report in Prevounce, review it, and send it to your biller. Getting reimbursed for Chronic Care Management has never been easier.
Preventative services have been incorporated into many of Medicare's quality measures in their Merit-Based Incentive Payment System (MIPS).
By making preventative services easy to provide, Prevounce can be an important tool in meeting your MIPS goals. We automatically generate clear reports that outline the services you have performed that count towards individual quality measures. From these reports and your EMR, you can easily see how your quality measure performance changes over time, and report to Medicare when the time comes.
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