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BRC Client Project Profiles

Most clients we assist have either high volume, high complexity, lack of staff, or an expedited timeline. We work on Implementations, Maintenance, Optimization and Rebuilds.

Epic software

Memorial Health University Medical Center, Savannah GA. 612 bed tertiary hospital and Level I Trauma center. 55 Commercial, 1 Tricare, 5 Medicaid, and 8 Medicare contracts. Payor agreements and rate summaries were received from Managed Care and governmental factors from Finance. Rules were set up in Epic, and Data Courier used to move to testing environments. Testing results sent to Managed Care and/or Finance for approval.  Monitored the results in Production to adjust contracts as needed. Coordinated weekly contracts review meetings. Set up models to support the contract negotiations. Participated in the Epic 2017 upgrade to assure all contracts & enhancements updated successfully. Trained newly hired MHUMC staff in contract maintenance and modeling. Maintained contracts using 3M and Epic logic.

Dayton Children’s Hospital, Dayton OH. 155 bed specialty hospital and multiple clinics. BRC has worked with Dayton Children’s since 2005. Assisted with reports and contracts on their previous Ascent® system. BRC served as the main technical support for the implementation of the Epic HB and PB contracts, as well as conversion of expected reimbursement reports.  Participated in two upgrades, one from Epic 2012 to 2014, and one from Epic 2015 to Epic 2018. BRC maintains 24 Hospital contracts including Ohio Medicaid with EAPGs and 59 Professional contracts including specialty and Anesthesia contracts.

Henry Ford Health System, Detroit MI.  Five hospitals totaling 2300 bed and over 35 outpatient facilities. Completed new build and implementation of 5 Medicare Epic contracts for state mandate to provide patients a self-pay discount as a percentage of Medicare reimbursement. First Epic client to successfully build Self-pay discounts as a % of Medicare reimbursement. Developed workflow and written procedure documents for Data Courier and Change Management process. Trained Contact Managers to maintain Epic Contract Maintenance application.  Created transition documentation as requested.

UCLA Medicare Center, Los Angeles, CA. The UCLA Medical Center is part of a network of more than 170 primary care practices throughout Southern California with four main hospitals including Ronald Reagan UCLA Medical Center; UCLA Medical Center, Santa Monica; UCLA Mattel Children's Hospital; and the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA.  Implemented new Contracts built for new reference lab implementation. Successfully migrated Medicare APC reimbursement from 3M external grouper to Epic Contract Maintenance. Built, tested and implemented Transplant contract enhancements. Completed requests for break/fix issues as assigned.

Baylor Scott and White, Temple TX.  The largest not-for-profit? healthcare system in Texas and one of the largest in the United States. Baylor Scott & White includes 48 hospitals, more than 800 patient care sites, more than 7,800 active physicians, over 47,000 employees and the Scott &? White Health Plan. Contract Optimization, staff training and Upgrade Projects. Trained staff. Assisted with contract updates and Epic Upgrades. Performed variance root-cause analysis and advised client of trends. Mitigated Epic technical issues working with Epic support teams on behalf of client.

Children’s Healthcare of Atlanta, Atlanta, GA. Three hospitals, Six Urgent Care, and 27 outreach locations. Completed successful Implementation and maintenance of 3 tier system, 200 + hospital and professional billing contracts in Epic and MedAssets. Participated in multiple upgrades and system updates. Performed contract modeling for contract proposals. Assisted Deloitte and Touche with annual contract and reimbursement audits. Managed Care liaison assisting with technical issues between Payors and the organization. Variance reporting and analysis.

Payment Integrity Compass ®

University of Washington Medical Center, Seattle WA. Payment Integrity Compass. 54 Commercial, 58 Medicaid, 32 Medicare Advantage contracts. This included several back dates to bring contracts to current. We read the paper contracts and used them to create or update contract interpretations/rate matrices. Used the interpretations to set up the contract rules in the software. Contracts were tested and adjusted until at least an 80% no variance threshold was reached. Contracts were then put into production, recalculated, reviewed and any calculation issues or errors corrected.

Providence Health & Services, Washington. Renton WA. A multiple facility system, BRC began working with two hospitals in Eastern Washington to help with contract coding, training, and report writing on the Ascent® system.  After a merger, BRCassisted the Western Washington facilities. We to set up several complex contracts in Payment Integrity Compass®.  Helped to resolve several data issues between Meditech and the Contract Management System.

Proprietary Client. Maintained quarterly updates for Medicare, Medicaid and Tricare for several hospital systems.

Ascent® and Keane Optimum® software

NorthBay Medical Center, Fairfield, CA. A two facility system with 182 beds that BRC supported for several years. Supported Medicare, Medicaid, Tricare and commercial contracts in Ascent®  and Keane® contract management systems. Provided report writing expertise, contract coding for models to support negotiations and data utilities when needed. We assisted them in choosing and then converting to Keane®.  Advised the vendor in development of their contract modeling module.

Ascent® software

El Camino Hospital in Mountain View, CA. A two facility system with 450 beds. BRC worked with the Managed Care department, supporting the Medicare and Tricare contracts in their contact management system as well as assisting in SQL and Crystal Report writing and training.

Methodist-LeBonheur Healthcare, Memphis, TN. A four-facility teaching hospital system with 1300 beds, including the flagship Methodist University Hospital. Helped to implement their Denials Management System and Contract Management System. Trained MLH staff in how to maintain both systems including system setup, reporting, contract coding and revenue recovery.

Sentara Health, Norfolk, VA. A six-facility system. BRC provided report writing training for the Ascent® Contract Management System. Provided interim staffing for six months while they found a replacement, then trained the replacement until they were independently functioning.

References available on request.

Contact Jodi R Bloom

info@bloomroad.com

Principal