Nimitt’s team members are dynamic educators who are skilled at effectively conveying complex information to a range of audiences. We conduct specialized educational sessions, presentations, and skills-building trainings on a wide range of coding, billing, coverage, reimbursement, and compliance topics.
Popular sessions include a review of annual changes affecting various CMS payment methodologies, including OPPS, IPPS, and the MPFS; launch readiness strategy sessions and educational series for market access teams; provider reviews focused on improving hospital operations and reimbursement across a broad range of clinical service areas. Our team is deeply engaged in provider advocacy; inpatient and outpatient coding, billing, and coverage issues; and frequently contributes to leading industry conference presentations and publications on a wide range of topics.
Provider Reviews
Nimitt works with hospitals and health systems to improve internal operations and reimbursement. Our specialization in cell therapies (such as stem cell transplant [SCT] and CAR-T) is grounded in deep revenue cycle, coding, billing, and reimbursement knowledge; our team has been involved in successful advocacy efforts that have yielded significant improvements in Medicare reimbursement. Several of our advisors come from the provider setting and have first-hand knowledge of revenue cycle processes that are required to ensure patient access to novel therapies. We also work closely with finance, chargemaster (CDM), and managed care contracting teams to ensure best practices are deployed so providers can obtain complete and compliant reimbursement from all payers. Our programs are delivered both virtually or on-site, with the common goal of helping participants implement long-term and sustainable improvements in coding, billing, and reimbursement. Nimitt offers a broad range of other services to the provider community including auditing and monitoring engagements and on-call technical assistance about oncology coding, billing, coverage, and denial issues.
Tailored Strategic Planning
Nimitt provides in-depth and highly focused strategic planning discussions to address industry clients’ specific needs as they develop novel cell and gene therapies. Our team helps clients understand the intricacies of CMS reimbursement policies and creates coding and reimbursement roadmaps that provide proactive strategic guidance to ensure products are successfully brought to market. This includes analyzing applicable physician and facility billing, and exploring potential benefits of new codes, New Technology Add-on Payment (NTAP), pass-through status, and other reimbursement mechanisms. We coordinate efforts to implement this strategic guidance and work with market access and field teams to facilitate successful product onboarding with providers. Our customized materials utilize clinical and reimbursement scenarios tailored to the client’s unique challenges and goals. We offer a wide range of tailored two- to eight-hour programs that can be delivered on-site or remotely. Our long-term support services focus on delivering technical assistance via office-hours, Question/Answer sessions, or other mechanisms so industry can successfully onboard their new therapies.
Presentations and Publications
Nimitt helps providers and other stakeholders stay informed about changes in federal regulatory guidance and front-line challenges in implementing new coding, billing, and coverage requirements. Our team frequently presents on new ICD-10 and CPT/HCPCS codes and CMS’ quarterly and annual updates to the OPPS, IPPS, MPFS, and other federal rules and regulations. Our team routinely speaks at regional and national conferences presented by leading organizations such as AHIMA, AHLA, ASTCT/Tandem, HCPro, HFMA, NAHRI, NMDP, and others. Nimitt helps increase industry awareness of coding, billing, and reimbursement issues by publishing articles, white papers, and news briefs on health care regulation and cutting-edge policy issues. Jugna Shah co-created several leading publications on OPPS/APCs, including HCPRO’s APC Answer Letter, APC Weekly Monitor, and Briefings on APCs. Her bi-monthly Briefings on APCs column, “OPPS Advisor,” highlighted important issues for providers. Ms Shah has authored several books on OPPS implementation and reimbursement, including OPPS Drug Administration Strategies and The Drug Revenue Toolkit.