Services & Products

QMS Focus

QMS Focus is a dialysis specific billing application which is designed exclusively for dialysis management. By maintaining a regular application enhancement schedule, the system is able to address all the unique reimbursement issues confronting today’s dialysis facility, due to complex and ever-changing regulations.

QMS Focus gives dialysis managers a quick, efficient means of receiving full payment for services performed and uses this information to produce reports on facility performance and financial health of a dialysis enterprise. Along with exceptional support and training, QMS Focus is intuitive and easy to use, which increases productivity and most importantly efficiency.

QMS Focus features client/server architecture, an Oracle relational database, and a true Windows™ client user interface. Its open architecture allows it to be used with a wide range of other applications, among them, QMS’ clinical application, QCS.

BILLINGS & RECEIVABLES

QMS Focus Helps Maximize Revenue per Treatment

  • Assures billing of all appropriate charges to specific payors without limit
  • Provides ease in keeping prices current for all payors
  • Allows payor-specific reimbursement pricing to capture revenue from non-Medicare payors for Medicare routine items
  • Eliminates the tedium of tracking the complex payor rules by allowing the user to configure all insurances in terms of which items will be reimbursed, the expected days to reimbursement, if authorizations are required, and the format expected for the claim (See fig. 1)
    Fig. 1:Insurance Setup Options Figure 1: Insurance Setup Options

QMS Focus Reduces Size of Accounts Receivable

  • Ensures rapid submission of claims to payors using Electronic Claims Submission (ECS)
  • Allows speed and labor-saving in posting of payments — Electronic Remittance Advice (ERA)
  • Reduces staff effort to post claims to A/R, post cash and generate secondary claim
  • Avoids delay in collection efforts. A/R staff is advised of when payment is expected so they can focus on collection efforts
  • Streamlines collection effort. A/R and collection information is readily available to A/R reps and collections staff via a wide range of tailored reports
  • Assures that all charges are captured. All treatment items for all patients are captured, allowing the application to determine what is billable to specific payors
  • Tracks actual expected revenue when commercial rates are billed and different contractual rates are paid by insurers (see fig. 2)
    Figure 2: Accounts Receivable Screen Figure 2: Accounts Receivable Screen

Reduces Infrastructure Requirements of a Billing Department

  • Allows users to profile all payors, eliminating the tracking of complex payor rules
  • Provides a specific function to automatically rebill when there are changes in the primary, secondary or tertiary coverage that will reverse charge, credit, and/or adjustment entries and create the new charges credit, and adjustment entries based on the new requirements
  • Retains set up history so that previous bills can be reprinted and analyses of previous periods can be done after the close of the month

Provides Useful Financial and Operating Parameters

  • Captures financial reporting for the overall operation as well as by individual facility or groups of facilities
  • Effortlessly permits tracking of key parameters such as hematocrit and URR for individual facilities and groups of facilities with comparisons that managers can use to spot problems or opportunities
  • Provides managers with details of resource utilization and use of expensive medications such as EPO, Calcijex, IV iron, Zemplar, etc. and the ability to evaluate these parameters for individual facilities and compare any of them to the overall organizational results
  • Helps managers track and analyze absence rates, such as treatments missed due to hospitalization, dialysis at other facilities, or no-shows
  • Calculates gross mortality for both individual facilities or an entire enterprise for one quality initiative

Responds to Regulatory Changes and Customer Feedback

  • Is 100% compliant with new and evolving HIPAA rules
  • Is constantly updated with changing Medicare and local Medicaid regulations at no extra charge to the customer
  • Is continually being enhanced, providing new reports and analyses on a frequent basis and often at the request of individual customers for the overall benefit of our large customer base
  • QMS has an extensive customer support group whose sole commitment is to help our customers get maximum benefit from our applications. This group is available via toll free numbers throughout the business day