BSA Healthcare
Data Mastery Transforms Emergency Medicine Reimbursement

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teering the financial intricacies of emergency medicine requires more than just a cursory understanding of billing and coding; it demands an intimate knowledge of this unique specialty and the interplay between revenue and compliance.

Enter Bettinger Stimler & Associates (BSA Healthcare), a company that not only understands the theoretical underpinnings of emergency medicine revenue cycle management but brings to the table real-world experience from the frontline of emergency and hospitalist medicine. Led by two emergency physicians — Dr. Jeffrey Bettinger and Dr. John Stimler — BSA Healthcare stands out for its data driven approach to maximizing revenue for emergency medicine providers and technical services. This leadership duo brings a rare combination of clinical expertise and business acumen, enabling clients to identify coding and billing strategies that yield optimal financial results without compromising compliance.

Serving nearly 70 percent of the emergency medicine industry over the last twenty years, BSA Healthcare has gathered proprietary, confidential all payer data representing millions of emergency medicine encounters. This proprietary data, kept strictly confidential, allows BSA Healthcare consultants to measure a practice against its peer organizations.

“Over the last twenty years, we have collected all payer E/M distribution data representing millions of emergency medicine claims. This data offers our clients a unique opportunity to measure their own benchmarking data against the rest of the industry. But we don’t stop there. Through our robust array of emergency medicine consulting services and products including coding and documentation auditing and coding reference tools, AR valuation, billing reports review, and practice management services, we are able to tailor our consulting engagements to meet each client’s needs. If coding methodology changes are necessary, we offer live coder training programs that teach coders how to apply our proprietary objective criteria to the medical decision-making component of the documentation guidelines. If provider documentation needs improvement, we offer provider training and follow-up tools for that as well. Whatever your emergency medicine consulting needs, we have a solution,” says Jennifer Cipriani, VP of Sales and Client Services.

BSA Healthcare’s clientele is as varied as the challenges they face — from hospital systems eyeing the bottom line, to academic institutions seeking to align the needs of compliance and revenue departments, to private practices striving to maximize reimbursement — each client receives a bespoke service, tailored to their circumstances.

This personalized approach highlights BSA Healthcare’s ethos — understanding the individual story behind each organization, driving them forward not as a client, but as a partner in a shared journey toward achieving excellence.

Leveraging its extensive data repository and expertise, BSA Healthcare validates internal data and coding suggestions, providing clients with the necessary support to defend each code choice, particularly in cases that are down-coded by governmental and other commercial payers. The results speak volumes, with an impressive 90 percent success rate in overturning down-coded claims at the uppermost levels of the appeals process — a testament to the defensibility and effectiveness of BSA Healthcare’s emergency medicine and hospitalist code choice criteria.

The real impact of BSA Healthcare’s work shines through in the success stories of its clients. Take, for instance, a recent case where a client uncovered significant revenue loss after switching billing and coding vendors. Through comprehensive data review and benchmarking analysis, BSA Healthcare helped the client recoup millions of dollars in lost revenue by auditing records and comparing results to internal benchmarking data.

What sets BSA Healthcare apart is the unmatched proficiency in emergency and hospitalist medicine it gathers from its founders. Dr. Bettinger’s competence in billing, complemented by Dr. Stimler's mastery of coding and compliance, creates a dynamic duo uniquely equipped to understand and address the multifaceted challenges encountered by emergency medicine providers. Dr. Bettinger’s work with governmental leaders, and Dr. Stimler’s ongoing practice in a level-one trauma center, ensure that the company remains deeply connected to the frontline realities of emergency and hospitalist medicine.

This expertise is augmented by a team of seasoned consultants who work hand in hand with clients, facilitating seamless engagements and guiding them through the intricate terrain of emergency medicine reimbursement. BSA Healthcare stands alone in its ability to harmonize the objectives of various departments within hospitals or physician groups, facilitating collaboration and aligning objectives through an understanding of shared goals and individual departmental responsibilities.

In an industry where every dollar results in better patient care, BSA Healthcare’s expertise and dedication to client success is invaluable. As hospitals and physician groups navigate the dynamic landscape of emergency medicine, having a partner like BSA Healthcare’s unmatched data-driven approach makes all the difference.