PHSSC Services

Professional Healthcare Support Services offers a wide range of services to enable our healthcare clients to keep pace with ever-changing government guidelines and regulations.

HIPAA Solutions

PHSSC offers a full range of services focused on the administrative simplification, privacy, and security rules of HIPAA. The approach of PHSSC starts with the assessment, identifying key process areas and performing gap analysis to determine the appropriate actions needed to achieve HIPAA compliance. PHSSC then builds a Project Office based on the needs of the client to oversee and assist the implementation effort. 

At PHSSC, we have developed requirements tracking tools to clearly define HIPAA compliance requirements and apply them to your specific environment. These tools are then used throughout the lifecycle of your implementation effort. We feel these tools are proven as they were used in a recent HIPAA assessment project for the State of Iowa's Department of Human Services. 

In addition to assessment services and implementation assistance, PHSSC can provide education, communication and testing support to satisfy your HIPAA compliance efforts.

Healthcare Provider Consulting Services

Medicare Cost Report Support Services - Our professional staff are recognized experts in all aspects of Medicare cost reporting: from data gathering and verification, to cost report preparation, to audit review, and finally to successful appeal resolution, if necessary. They have heavy experience with Home Office, hospital, skilled nursing and rehabilitation facility, and outpatient facility cost reports. We stand ready to bring our expertise to providers in any phase of the cost reporting process, including consultation on complex reimbursement issues, reviewing the accuracy of Intermediary audit adjustments report, and other special projects. 

Medicare Regulation Compliance - We conduct provider-training seminars teaching the latest Medicare coverage issues. Our employees continue to research the latest developments in Medicare regulations, and have served on numerous committees that have developed Medicare policies. 

Medicare Contractor Support

Medicare COBOL Programming - Our professional staff consists of some of the most experienced Medicare programmers in the country. We are very experienced in writing programs for the Florida Shared System and the Arkansas Part A Shared System. We are experts in error identification and have supplied numerous direct programming solutions. We offer both onsite assistance and telecommuting support. 

Administrative Audit - Our professional staff have been involved in numerous administrative audits of the Final Administrative Cost Proposal (FACP) including a recent OIG review which resulted in no audit findings for a review covering 3 Fiscal Year FACPs. We are well versed in identifying allowable and allocable expenses. 

Medicare Financial Statement Reviews (750/751) - Our staff has prepared 750/751 reports and withstood numerous related audits from HCFA and the Office of the Inspector General. We are capable of reviewing your processes to improve your financial reports to withstand audit reviews. Our Vice President was a member of HCFA's Financial Technical Advisor Group (TAG), which was instrumental in the development of the 750/751 regulations. 

Medicare Audit and Reimbursement - Our staff has performed numerous Medicare cost report audits on providers across the United States including home offices, hospitals, skilled nursing and rehabilitation facilities, home health agencies, and outpatient facilities. We are very experienced in reviewing any type of Medicare cost report, and are considered experts in the industry. We are available for cost report audit, issue consultation, assistance with cost report reopening projects, and special audit and reimbursement related assignments. We also have proven expertise in successfully addressing provider cost report appeals.

EDI Solutions

EDI Consultation - Our staff includes experts in EDI services including the configuration of electronic claims transmissions and related processes. We also have expertise in helping you establish processes for the receipt and interpretation of electronic remittance advices. 

EDI Related Applications - We are currently in the process of developing software applications to help the healthcare provider community with current and future EDI business functions.

Project Management Services

PHSSC provides project management services specializing in the healthcare industry. 

Our project managers have led major system renovations of Medicare's claims processing system. 

We have served as the project manager for claims processing system transitions for the nation's largest Medicare fiscal intermediary. 

One of our managers served as the project officer for the data center transition of four fiscal intermediaries from the Trigon Data Center to the Arkansas Data Center, maintaining connectivity and production for over two thousand providers as they moved their entire claims processing operations from Virginia to Arkansas. 

We also managed and assisted in several Y2K projects, including establishment and maintenance of the entire project office for the Blue Cross Blue Shield of Rhode Island - Medicare Year 2000 readiness effort.