Rapport Case Management

A QHR Health Shared Service

Rapport Case Management™ is a QHR Health Shared Service designed to provide 24/7 operational, staffing, and remote case management capabilities for independent hospitals across the U.S.

  • Maximize reimbursable revenue opportunities
  • Minimize payor denials
  • Avoid unnecessary write-offs, financial penalties, and incorrect patient status
  • Improve patient and staff experience

The Five Keys to Rapport Case Management:

1. Utilization Management:

  • Improve revenue capture through decreased denials, and appropriate status designations
  • Enhance observation management and compliance utilizing the 2-midnight rule
  • Sustain timely same-day admission reviews 7 days per week.
  • Generate better payor relationships, managed care revenue capture and decreased denials
  • Impact length of stay through daily coaching huddles to drive patient throughput
  • Ensure UM processes are aligned with CMS conditions of participation and OIG regulations
  • Improve inpatient and observation clean claim percentages

2. Physician Advisor Services:

  • Improve timely secondary review of cases to assure appropriate status and timely discharge
  • Ensure accurate guidance and assistance completing payor peer-to-peer appeals
  • Reduce concurrent and retrospective denials
  • Provide just-in-time physician education on documentation to support medical necessity as required by external reviewers and RAC
  • Access expert physician advisor services for hospitals with no internal physician advisor.

3. Denials Management:

  • Reduce final denials and downgrades resulting in improved revenue
  • Create timely submission of appeals through all appeal levels
  • Receive regular reporting on denials and appeals.

4. Clinical Documentation Integrity:

  • Report appropriate patient acuity levels by capturing the severity of illness, risk of mortality, and the care provided
  • Work DRG assignment to establish expected length of stay
  • Align documentation with CMS and OIG regulations
  • Reduce risk of medical record integrity/denials from incomplete documentation with external reviewers and RAC
  • Improve appropriate code selection for more accurate reimbursement

5. Case Management Leadership Resources:

  • Assure continued Case Management operations during a leadership transition:
    • Improved departmental operations during transition period
  • Understand current Case management operational strengths and weaknesses
  • Implement successful onboarding and orientation for new case management leader(s)
With QHR Health’s Rapport Case Management capability, we will collaborate with you to:

Deliver a 24/7, best-in-class case management capability that:

  • Improves the patient and care team experience
  • Captures reimbursable revenue
  • Provides economies of scale and access to industry case management experts, regardless of your location

 

We stand by ready to help you create a stronger rapport between you, your patients, your provider community, and your payors. Let’s start a conversation.