Nimitt Consulting helps clients succeed in the constantly changing regulatory arena and deliver health care in an effective, cost-efficient manner. We help our clients address the clinical, operational, financial, and reimbursement implications associated with payment systems, particularly around emerging medical technologies.
Services include regulatory and compliance reviews, financial impact data analyses, market access and reimbursement strategic planning, audits, advocacy, and training. We bring insights from our significant claims data analyses to inform various research questions and reimbursement questions.
REGULATORY 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 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 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.
EMERGING THERAPIES
Nimitt provides education on emerging therapies, drugs, devices, and diagnostics. Breakthrough therapies, such as CAR-T cellular therapy, present unique challenges for implementation for hospitals, clinicians, industry associations, manufacturers, and payers. Nimitt’s deep background in payment policy and reimbursement issues — and long experience in coding, billing, revenue cycle, and finance — provide holistic guidance in this area. Clients are prepared to overcome regulatory, operational, and financial roadblocks that would otherwise impact plans to provide and/or operationalize breakthrough therapies. Nimitt’s understanding of the constraints faced by hospitals and providers that seek to adopt new therapies, drugs, or devices gives clients much-needed context, and leads to better outcomes in commercialization plans.
BMT/SCT PROGRAM REVIEW
Nimitt has expertise and deep knowledge on reviewing Bone Marrow and Stem Cell Transplant (BMT/SCT) programs in terms of their accurate reporting of donor and recipient costs, pricing, charge description master (CDM) set up, correct cost reporting, and how charges impact current and future Medicare payment. These reviews identify opportunities for rebilling, including mitigating issues that lead to missed or late charges, and analyzing workflows and processes to improve how data and information flow through the organization. There are many moving parts to BMT/SCT programs, and for hospitals expecting to provide access to emerging cellular therapies, now is the time to undertake a review to ensure that your program functions optimally and receive appropriate reimbursement for the services provided.
For more information Nimitt’s provider review service, please click here.
