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Health Care Advisory Services

Nimitt helps provider and industry clients stay up-to-date and in compliance with legislative and regulatory changes that impact coding, billing, access, coverage, and reimbursement. We have broad and deep experience with CMS’ payment systems, standard coding and billing systems, claims data, and national data sets. This enables us to inform clients about the impact of proposed and final regulatory changes; advocate with payors; recommend reimbursement approaches for new and emerging technologies; and use data analyses to inform future regulations, reimbursement, and day-to-day provider operations. For industry clients, our popular, day-long white board session helps kick-off market access and reimbursement strategy work.

Regulatory Review and Analysis

Nimitt provides expert analysis of the operational and financial implications of changes in existing and proposed Federal policies associated with payment, coverage, coding, and billing. We conduct in-depth analyses of Proposed and Final Rule changes and prepare impact analyses of annual payment rate changes and new initiatives. We help clients respond to the resulting operational and financial impacts. We also inform our clients’ advocacy efforts to minimize provider burden, simplify operations, expand patient access, and protect reimbursement. Our comments and alternate proposals have been accepted by CMS and its contractors, resulting in material payment and policy changes. We credit our advocacy successes to the use of data-driven methods supplemented by real examples from provider experiences.

Improving Provider Operations

Nimitt offers many services to support and enhance provider operations. We use data-driven analysis to help our clients identify revenue opportunities and minimize their compliance risks. We conduct revenue integrity assessments, charge master structure and design reviews, price transparency analyses, charge capture assessments, compliance and claim integrity audits, denial management, defensible pricing, internal policy and procedure reviews, and more. We also provide patient financial advocacy services to reduce uncompensated care and collection costs, and build loyalty and reputation capital. Our mission is to reduce front-line staff’s operational burden and enable the implementation of payment, coding, and billing changes in a timely and cost-effective manner.

Provider Advocacy Initiative

Nimitt works closely with hospitals, non-profit organizations, industry associations, and for-profit entities to improve current and proposed regulations by spearheading advocacy efforts. In 2003, Nimitt created the Provider Roundtable (PRT); a forum that unites the voices of hospital representatives on the front lines of OPPS/APC implementation and management. For over a decade, the PRT has submitted written and oral comments to the Federal government, advisory bodies, and contractors about the impact of proposed payment system and policy changes on hospital operations. Many of the PRT’s recommendations have been adopted by CMS for the Medicare program, thereby minimizing provider burden and improving reimbursement.

Click here to learn more about the PRT and its communication and advocacy efforts.

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