Our Services

Relationship ManagementBusiness StrategyHealth Policy
Relationship Management

Health care is all about building and maintaining relationships – whether you’re talking about relationships between providers, payers or patients. The Gordon Policy Group understands the critical role of managing relationships and how they impact business. We help you work effectively with others in your network, reaping rewards financially as well as in goodwill.

Payer Relationship Management

  • Health Care Provider Network Development
  • Provider Network Management
  • Provider Contract Review and Analysis

Government Relationship Management

  • Educate client on government’s role and impact on business and clinical decisions
  • Provide navigational support to client when interacting with regulatory or legislative entity

Community Relationship Management

  • Educate and Inform client on Community and Professional Associations impact on business and clinical decisions
  • Support clinician with coordination of Community and Social Service Organizations’ resources that are aligned with patient need
Business Strategy

Many organizations suffer from administrative and functional weaknesses that result in heavy financial losses. Our data driven review process allows us to analyze and determine operational best practices, enabling your organization to improve to peak performance levels.

Data Analytics and Informatics

  • Care Management Outcomes Studies
  • Program Return on Investment (ROI)
  • Service Level Agreement (SLA) analysis
  • Custom File Feed Development
  • Data Warehouse Consulting
  • Pre-Sale and Opportunity Analysis

Operational Assessment

Claims Management:

  • Utilize analytics to evaluate overall billing process resulting in reduced cost and increased efficiencies
  • Identify Underpayments and Overpayments
  • Comparison of service cost to fee schedule
  • Coding errors identification

Revenue Cycle / Accounts Receivable (A/R) management:

  • Appeals and Grievances (non-clinical) management
  • Assessment of current status and opportunities for efficiencies and improvements
  • Management of Provider’s claims projects > 180 Days past due

Human Resource Support

Virtual Solutions utilize remote staff including administrative and clinical personnel to achieve business objectives. Virtual Solutions can reduce administrative costs, improve revenue collection, and increase patient compliance and satisfaction.

  • Customer service including scheduling of appointments, appointment reminders, and post appointment follow up calls.
  • Insurance prior authorization, service denial management and appeals
  • Billing, payment monitoring and collection services via website and payment portals

Health Insurance Revenue Strategy

  • Financial Evaluation of Payment Arrangements, i.e. contracts

Healthcare Document Conversion

  • Medical Chart Scanning/Indexing
  • Clinical Data Entry and “Meaningful Use” Abstraction
  • Cloud Based Document Management
Health Policy

The Gordon Policy Group is adept at advising your organization in the area of health policy. Whether your concerns are with delivery methods or managing the fluidness of the current insurance environment, our aim is to uncover solutions that enhance the services you offer.

Health Care Delivery Models

  • Telemedicine / Telehealth
  • Accountable Care Organizations
  • Medical Home
  • Dental Home
  • Preferred Networks
  • Managed Care

Health Care Payment Trends

  • Fee for Service
  • Capitation
  • Value Based Purchasing
  • Pay for Performance
  • Bundled Payments

Health Insurance Trends

  • Affordable Care Act
  • Medicaid / Medicare Managed Care
  • VA / Tricare / Military Health Systems
  • Long Term Services and Supports