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Zimmerman Launches Clinical Compliance Initiative to Assist Hospitals with Patient Classification and RAC Challenges
Milwaukee, WI (February 14, 2008) – The Clinical Compliance Initiative, formed in January 2008 by Zimmerman, LLC in partnership with Sure Decisions, focuses on strategies that help healthcare providers determine the appropriate admission status of patients, allowing hospitals to improve revenue and reduce regulatory exposure.
This new working council combines the best-practice research, performance measurement capabilities, and experienced facilitation of Zimmerman with proven and future-forward strategies used by better performing hospitals. It also leverages results of Zimmerman’s research study Appropriately Classifying Admission Status to Optimize Reimbursements and Reduce Regulatory Exposure.
Improperly classifying patients results in revenue leakage. Only 20 misclassifications per month could result in as much as a $1.2 million loss per year.
“Hospitals that join the Clinical Compliance Initiative can expect to see a .5% net revenue improvement, a reduced cost-to-collections ratio, and reduced clinical denials,” said Michael Zimmerman, president and CEO of Zimmerman. “In addition, physicians, case management staff, and patient financial services should experience improved efficiency.”
Hospitals are also at risk for regulatory exposure and audits as part of the Recovery Audit Contractors (RAC) program, which determines over- and underpayments made by the Centers for Medicare & Medicaid Services. Membership in the Clinical Compliance Initiative will increase RAC readiness and help hospitals improve compliance training, patient classification, and claim-appeal processing.
During quarters one and two of 2008, Zimmerman is selecting 20 founding charter members of the Clinical Compliance Initiative. Charter members receive a preferred contribution fee for participation in the Initiative and, upon commitment, will be assigned a dedicated physician advisor to begin the short setup required. Zimmerman anticipates net revenue improvements and compliance reduction to be noticed within 60 to 90 days of initiation.
Working-council membership communities bring together the collective expertise, process know-how, and performance benchmarking data of progressive hospitals and health systems. Members report numerous benefits from their hospital’s participation in these groups. Perhaps the most obvious benefit is that peer executives share a common platform for ongoing performance improvement, which drives the alignment of strategic objectives and tactical agendas. With each new council joined, member management teams enjoy broader and deeper issue coverage, ensuring support across the full spectrum of major initiatives.
Zimmerman, LLC With 22 years experience as a niche provider of healthcare revenue cycle best practices, we have published numerous thought leadership and benchmarking reports, presented at hundreds of RCM educational conferences, and have co-led close to one thousand revenue improvement initiatives at hospitals nationwide. In short, our extensive research, industry experience, and ability to get results have positioned us as one of the nation’s top-tier solutions providers for revenue cycle management. Our revenue cycle capabilities broaden and expand each year. As the complexity and sophistication of our clients' challenges have grown along with their requirements to achieve higher levels of performance, Zimmerman has developed into a continuously improving organization that can help clients achieve their goals.
