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Monthly Archives: March 2016

Project Management

Posted on March 18, 2016 | Categories: Program and Project Management, Program Manager, Project Manager | Posted by: admin


Project Management


The Project Manager is responsible for managing all aspects of the project throughout the project s lifecycle Initiation, Planning, Execution, Control and Closure. This includes ensuring that all the project deliverables and outcomes are implemented on time, on budget, and within scope, to meet the expectations of the client i.e. the Project Sponsor and the Leadership.


Scope Management

  • Able to sometimes manage concurrent projects
  • Ensure that the project includes all the work required, and only the work required to complete the project
  • Ensure the project scope is adequately defined and agreed upon by all stakeholders
  • Manage projects with moderately defined, complex, multi-faceted scope, with several project dependencies
  • Manage projects with scope that impact across profit centers, support centers
  • Works closely with project sponsors to ensure requirements are complete, accurate and measurable


Schedule / Time Management

  • Ensure that any project change requests are assessed for impact to schedule, and that approved schedule changes are implemented
  • Ensure that appropriate duration and labor estimates are prepared and maintained for project efforts
  • Ensure that project resource time estimates are accurately reflected in the corporate project management tool, to facilitate reporting on actuals for cost estimates
  • Establish & maintain detailed master project work plan using the corporate project management tool
  • Monitor project progress against baseline schedule


Risk Management

  • Identifies, tracks, manages and resolves project issues and risk
  • Performs risk analysis and assist in the development of risk response plans


Financial Management

  • Communicate / report financial performance throughout project lifecycle
  • Ensure that any project change requests are assessed for impact to budget or business case and that approved cost changes are implemented
  • Ensure that initial project estimates & financial forecasts are complete with sufficient level of detail to support baseline estimates
  • Monitor the status of the project from a cost perspective
  • Responsible for overseeing a project budget of $1million plus
  • Throughout project, ensure that project budget/actuals are accounted for accurately, and in a timely manner

Quality Management

  • Ensure that project deliverables Charter, BRDs, Test Plans etc. meet quality standards and are approved in a timely manner
  • Ensure that project approach deploys adequate quality assurance techniques in accordance with Client standards


Resource Management

  • Able to interface with stakeholders for each project
  • Manage a project team & resource team – Dev, QA & Prod
  • Promotes proper resource management by assigning clear ownership in the project schedule, with resource forecasted at appropriate levels

Relationship Management

  • Managing the expectations of and influencing several diverse stakeholders, through effective communication and well-tuned interpersonal skills, is critical to project success.
  • The project manager must be client focused and is expected to manage relationships and expectations.


Leadership Management

  • Act as a change agent where necessary, and motivating the project teams in support of meeting the project and business objectives are key competencies in this leadership role.
  • Throughout the project s life cycle, the project manager must also remain focused on driving the team and maintaining momentum.


Continuous Improvement

  • Applying lessons learned from previous projects to current projects is another way to ensure continuous improvement.
  • Determining which project management tools are best suited and effectively using those tools to increase the likelihood of project success is a key decision that project managers must continuously make when managing projects.


Communication Management

  • Escalates and resolves issues via proper communication channels
  • Institutes effective project related internal and external communication
  • Maintains and distributes required project documentation and performance information, including status reports and progress measurements


Need help with Project Management, reach out to us

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Project Management for Insurance & HealthCare

Posted on March 18, 2016 | Categories: Account Manager, Agency Systems, ALIP, Analytics, Change Management, Claims, Clinical Services, Consulting, Development Project Manager, Document Management, EMR / EHR, ePrescription, eRx, Health Insurance, HealthCare, HealthCare IT, Insurance IT, IT Services, Medicare, MLTC, Mobile Health, PACE, Payers, PBMs | Posted by: admin

Project Management for Insurance & HealthCare


  • Casualty Insurance
  • Health System
  • Hospital Care
  • Life & Annuity Insurance
  • Property Insurance
  • Physicians Group
  • Inpatient
  • Out-Patient
  • Emergency Room


PMI approved Project Management – Scope, Time and Cost


  • Change Request Management – identifies and develops strategy for changes in scope, schedule, and cost.
  • Communications Management – creates and manages communications with stakeholders providing relevant details for informing and decision making in status reporting.
  • Cost Management – develops, monitors, and assesses project budgets through the entire project life cycle providing full transparency to stakeholders.
  • Documentation Management – Creates appropriate project documentation. Effectively negotiates tradeoffs between scope, schedule, and budget
  • Communication Management – Excellent communication, interpersonal, Presentation and written skills.
  • Implementation and Transition Management – creates transition plan, identifies lessons learned, and applies the lessons learned to future projects.
  • Integration Management – identifies and manages project interdependencies.
  • Quality Management – identifies relevant quality standards and defines governance, communication, and quality processes across SDLC – Dev, QA and Prod stages
  • Resource Management – identifies appropriate staff, defines roles and responsibilities, develop project organization chart and governance structure.
  • Risk & Issue Management – identifies and creates mitigation plans for risks and issues. Utilizes available tools for identifying and tracking issues.
  • Schedule Management – creates, manages, and understands impacts to project scope, constraints, and schedule via MS Project Plan and CA – Clarity
  • Organizational Management – Ability to work well on cross functional project teams including IT and business subject matter experts

Call us for Project Management & Program Management

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Technology & Methodology for Revenue Cycle Management (RCM)

Posted on March 16, 2016 | Categories: Program and Project Management, Program Manager, Project Manager, RCM/EPM/CBO | Posted by: admin

Technology & Methodology for Revenue Cycle Management (RCM)


Revenue Cycle Management goes beyond

  • Conventional Claims Clearinghouses
  • It uses smart technology and an intuitive interface to help receive payments faster while reducing the administrative burden on the office staff
  • Intelligent analytics pinpoint trends affecting revenue cycle, that dramatically reduce accounts receivable and improve cash flows


Revenue Cycle Management (RCM) can help standardize, streamline and automate tasks related to

  • Billing and collections
  • Claim tracking and rework
  • Patient access
  • Payment posting



Revenue Cycle (RCM) is widely used in

  • Billing Services companies
  • Health System – Inpatients, Outpatient & Emergency Rooms
  • IPAs
  • Medical Group
  • Medical Practice
  • Physician Center Medical Homes (PCMH)


Stage of Revenue Cycle

  • Claims Submission Management
  • Edit/Error Management
  • Status Management
  • Denial Management
  • Remittance Management
  • EOB to ERA Conversion


Claims Submission Management

  • Submit claims instantly in standard and non-HIPAA standard formats*, and reduce or eliminate paper claims.
  • Submit claims in a batch or one-at-a-time, 24/7, to send to the health plan multiple times throughout a day.
  • Get real-time notification of electronic receipts and line-item, detail-level tracking.


Edit/Error Management

  • Benefit from automatic eligibility and benefit checks on submitted claims, ensuring completeness and accuracy.
  • Identify errors in real time, including HIPAA compliance, NPI and provider- and payer-specific errors.
  • Quickly see the fields to be fixed, plain-language summaries of each error and recommended actions for correcting them.
  • Use one standardized correction process for every payer, increasing efficiency for your staff.
  • View error patterns and trends in on-demand reports.


Status Management

  • Determine the status of pended claims with a daily automatic refresh.
  • Use automated searches and sorts to pinpoint claims that need the most attention, including unpaid, delayed and pended claims.
  • Search claim histories for proof of timely filing.
  • Find highlighted patterns, problems or delays in full lifecycle displays of individual or batched claims.


Denial Management

  • Accelerate cash flow
  • Adapt to all unique provider- and payer-specific rules in any practice-management system environment.
  • Create and control custom edits, including payer- and provider-based rules.
  • Create custom edits that fit organization’s business rules
  • Cut down on vendor costs by using a single integrated, standardized workflow.
  • Navigate a series of step-by-step screens for a user-friendly interface that cuts down on the need for programming resources.
  • Reduce denials with customized, up-front, provider-specific error identification.
  • Run eligibility during claim processing and reduce errors—ultimately, lowering the number of denials and speeding your payments
  • View the claim status, correct clearinghouse and payer edits, and resubmit the claim from a work queue


Remittance Management

  • Automatically post ERAs in the format required by most practice management systems.
  • Consolidate machine- and human-readable remittances into one common file feed, reducing the number of files to auto-post.
  • Track remits easily with plain-language explanations.


Analytics Management

  • Analyze, compare and monitor key business performance metrics for reimbursement, staff productivity, payer performance and code utilization.
  • Customize the system per user level, so answers to questions are simple and intuitive.
  • Provide transparency into business operations for even more visibility and control over your revenue cycle.


EOB to ERA Conversion

  • Achieve consistency and accuracy in posting while reducing costs of data entry and paper remittance handling.
  • Automated remittance and posting to automatically post all of payments, regardless of format.
  • Eliminate errors — and rejections — to expedite payments and account reconciliation.
  • View all remittances in a standard format.


For Technologies or Business Support related to Revenue Cycles, call us.

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