The Medical Director, Director of Nursing, Compliance Officer, and Case Managers make up a typical utilization review committee.  Each week they meet to analyze their weekly caseload; deciding what level of care to provide to each patient. This is a cost management measure instituted by medical groups, skilled nursing facilities, home health agencies, and insurance payers […]

Become efficient – Becoming efficient can take on many forms and can be achieved in a variety of ways.  Getting it right requires a systemic assessment of the core functions and processes of a DMEPOS operation.  Highly regulated and convoluted with unique scenario driven operating rules makes it easy for a DMEPOS become a target for […]

The bflow™ billing specialist is the gatekeeper for the organizations billing, collections and quality activities.  Their responsibilities include reviewing and evaluating signed detailed written orders for pertinent information and completeness, evaluating the patient’s medical records for pertinent information, creating notes with attachments or bookmarks identifying medical necessity within the chart notes, SOAP notes, correspondence and […]