Murer Consultants, Inc

Below are the newest Murer products:

Opportunities for Non-Acute Care Growth

As a recognized national leader in non-acute strategy, reimbursement, and development, Murer Consultants can provide hospitals, REITs and developers with consultation services in non-acute healthcare products to achieve profitable growth and a unique market position.

What Murer Consultants Can Do in Non-Acute Product Identification and Emerging Trend Analysis

We provide product identification and analysis of various services and products constituting the growing segment of non-acute care. Market data and information will include an in-depth description various services and products included within the scope of non-acute care including:

• Assisted Living
• FQHCs
• Concierge/Upper-End Self-Pay Services
• Vanity/Medical Day Spa
• Retail-Based Services
• Prevention and Wellness Programs
• Diagnostic Clinics/Differential Diagnostic Programs
• Primary Care Clinics/Convenient Clinics
• Employed Physician Practices
• Freestanding Emergency Rooms
• Long-Distance Monitoring
• Ambulatory Surgery Centers
• Complementary/Alternative Healthcare Services
• Outpatient Rehabilitation
• Behavioral Medicine
• Medication Management
• Chronic Disease Management
• Senior Living Communities
• Homecare
• Inpatient-Rehabilitation Services
• Hospice

We look at:

• Patient Demand and Other Market Response
• Physician Acceptance and Adoption
• Revenue by Service
• Profitability Ranges
• Reimbursement
• Information on Market Leaders
• Specialized Staffing Requirements
• Physician and/or Vendor Partnership Opportunities
• Regulatory Framework
• Other Factors Deemed Relevant

We provide trend analysis in:

• Healthcare Spending
• Structure of the Healthcare Marketplace
• Government Regulation and Medicare Beneficiary Coverage
• Healthcare Consumerization
• Cultural and Environmental Transformation
• Technology and e-health implications
• Performance-Based Models
• Medical Tourism
• Healthcare Personnel & Staffing Shortages
• Market Consolidation

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Analysis of Opportunities in Establishing Either a Free-Standing Emergency Room or an Urgent Care Center

One of the newest trends in facility development is the Off-Site Emergency Room. The development of Off-Site Emergency Rooms has been regulated by some states to require an operating room. Other states allow these facilities to function as an Outpatient Department that triages patients. The question for many health systems becomes whether the new facility should be an Emergency Room or an Urgent Care Center. A number of factors must be examined to answer the question properly. These include:

• Does the State proscribe conditions for compliance for free-standing emergency departments?
• What are the reimbursement differences between the different models of emergency care delivery?
• Can the department be provider-based under the regulations?
• What are the patient and community needs in the areas to be serviced?
• What is the host strategy to incorporate physicians into the model?

Murer Consultants is a national leader in the development of free-standing emergency rooms for a wide range of clients. Our series include regulatory, financial and community-need analysis.

Murer Consultants offers regulatory and financial analysis, as well as development, of urgent care centers or free-standing Emergency Departments. Murer Consultants can provide the following:

• Regulatory/Financial Analysis
  • Operational requirements under licensure regulations;
  • Operational requirements under Medicare regulations;
  • Operational requirements under Medicare for Type A and Type B facilities;
  • Reimbursement differentials between Type A and Type B facilities;
  • Provider-based requirements as applied to urgent care and emergency facilities;
  • Licensure and certification requirements relative to pharmacy, controlled substances registration and DEA registration;
  • Licensure and certification requirements relative to radiological imaging; gross revenue;
  • Licensure and certification requirements applicable to available services and staffing.
  • Identify national and local trends in urgent care and freestanding emergency facility utilization and reimbursement.
• CON Consultation
  • Need assessment
  • Preparation of CON Application and Supporting Materials
  • Expert Testimony
  • Strategy Development
• Need Analysis / Pro Forma Projections
  • Identification of Community Need and Support
• Urgent Care/Emergency Facility Development
  • Provide a detailed master development plan with time frames to serve as a blueprint within the first thirty (30) days after initiation of a development project. This comprehensive master plan shall address:
    • Federal and State regulatory compliance;
    • Organizational structure;
    • Finance/reimbursement;
    • Facility space utilization; and
    • Operating budget and staffing requirements.
  • Conduct a Strategic Planning Session with key individuals to confirm the scope of the project and to agree upon key points, procedures and decision making process.
  • Serve as the liaison with CMS and State regulators and the fiscal intermediary throughout the development project to assure compliance with regulatory requirements.
  • Prepare each new facility for licensure and Medicare certification. Such process shall include:
    • Preparation of State Licensing Packet;
    • Preparation of Medicare Certification Packet;
    • Filing of CMS Disclosure Form CMS-855A, Medical Federal Health Care Provider/Supplier Enrollment Application;
    • Filing of all additional required CMS forms including 1513, 1514, 1561, and 2572;
    • Assistance with Section 504 Civil Rights Policies;
    • Completion of Civil Rights Packet;
    • Completion of State Pharmacy Application, where applicable;
    • Completion of State Narcotics Registration, where applicable;
    • Completion of DEA registration; and
    • Completion of CLIA Application.
  • Preparation of the hospital for compliance with CMS standards including development of a plan for satisfaction of all requirements relative to Medicare Conditions of Participation, as applicable.
  • Advisement of staff and assistance with organization of materials to be presented to the surveyors at time of licensure and certification, as applicable, as well as serving as the liaison with State and Federal regulators, including DEA and CLIA offices, to assure completeness of licensure application and certification processes.
  • Advisement as to impact of new regulations for urgent care, emergency and provider-based facilities.
  • Preparation of Vendor Agreements for purchase of services from other hospitals or health care providers, as applicable.
  • Phone consultations throughout the tenure of this agreement.

For more information contact: Murer Consultants, Inc. (815) 727-3355

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Physician Coding Audit Services

Murer Consultants provides consulting services to evaluate and assess compliance with federal and state healthcare programs and related regulations to ensure appropriate and accurate physician coding for Medicare and Medicaid billing. Murer Consultants will review a random closed medical record sampling for each practitioner requested and offers on-site visit availability with expert physician coding affiliates to evaluate and assess various items.

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Physician Documentation, Medical Necessity and Coding Consulting Services

Murer Consultants provides guidance and counseling related to physician documentation, medical necessity concerns and coding practices. Our extensive knowledge in this practice area allows us to conduct medical record reviews and training seminars to assess and promote compliance with the Medicare Conditions of Participation for Hospitals. Murer Consultants is always on the cutting edge of healthcare and specifically addresses areas of scrutiny by regulatory agencies for the year at issue.

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Legislative Analysis

Murer Consultants views the understanding of existing proposed and lapsing legislation as one of the foundations of proper business management. Murer Consultants has a service that can be accessible by companies for rapid analysis of present or proposed legislations and the impact on the industry. For years, Murer Consultants has advised venture capitalists, investment bankers, for-profit companies and brokerage house analysts in the financial impact of legislative or regulatory actions. Most recent examples are: 1) the last refinements of the 75% rule for rehabilitation units and hospitals, and 2) the proposed changes in the outlier rates for Long Term Acute Care Hospitals (LTACHs).

The program at Murer Consultants consists of a yearly retainer that allows access throughout the year to the latest developments.

For more information, please contact Michael Murer at Murer Consultants:
Email: mmurer@murer.com
Telephone: (815) 727-3355

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FEMA Reimbursement Services

FEMA (Federal Emergency Management Agency) reimburses individuals and businesses, including healthcare providers, for expenses incurred as a result of natural disasters, such as hurricanes. The expenses covered are costs that would not be reimbursable under normal circumstances. FEMA has divided these expenses into seven types that are grouped under two categories:

• Emergency Work
  • Debris Removal
  • Emergency Protective Services
• Permanent Work
  • Roads and Bridges
  • Water Control Facilities
  • Buildings and Equipment
  • Utilities
  • Parks, Recreational Facilities and other items

There is a registration process for obtaining reimbursement under the FEMA program, which requires filing a Request for Public Assistance within 30 days of the incident that caused the damage. FEMA assigns a Public Assistance Coordinator to the case who validates the cost estimates specified in the application. It is vital, therefore, that providers maintain detailed documentation of their expenses.

The type of entity involved affects the manner in which FEMA disburses the reimbursement funds. For example, if the provider is a non-profit entity, FEMA may disburse the funds to the county, county hospital association or city rather than directly to the provider. However, this is a work in progress and details are still being worked out.

Since Hurricane Katrina, Murer Consultants has assisted more than 30 providers in applying for reimbursement under FEMA's public assistance project.

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