Business Consulting

Tejas Health Management offers expertise in many of the fastest changing and most complex aspects of health care delivery, management, and payment. With expertise in both Public and Private sector requirements, Tejas can help you navigate the business opportunities and payment strategies in many areas of the health care system.

  • Service Delivery and Reimbursement: Medicare, Medicaid, Commercial Insurance, Health Exchanges, TRICARE, and other payment programs all have different rules on what is covered and what is not. Tejas can help you navigate the complex array of payers to ensure that the services you deliver receive maximum available reimbursement.
  • Market Intelligence: Tejas maintains detailed knowledge of health insurance plans, their service agreements, and the services that they cover in both the public and private sectors. ¬†Understanding each potential payor, the membership that they serve, and the unique aspects of their benefit plans can enhance your reimbursements and overall revenue..
  • Business Development: Facilitating the development and negotiation of advantageous service contracts; presenting your available services in ways to meet health plan needs; implementing or redesigning services to meet growing market demands; applying for and securing new lines of business and profitable income streams.
  • Contract Consultation: Applying our experience with Medicare, Medicaid and Commercial Insurance as we review proposed contract language, contract changes, and new contractual opportunities to secure the terms most advantageous to your organization. Maintaining knowledge about ¬†reimbursement trends and advising on negotiations
  • Process Analysis and Improvement: Reviewing, analyzing and recommending improvements of business practices, from the front office to the back office, to secure appropriate reimbursement for services delivered and to ensure that business practices are efficient and cost-effective.
  • Claims Management: Assisting in implementation of claims and billing practices that ensure that services delivered receive the appropriate reimbursement under the terms of your contracts. This includes examining reporting and billing practices to maximize your payments.
  • Product Development: Identifying ways to combine and package your services to meet critical payor needs.
  • Revenue stream review: Ensuring that revenue streams are cost effective and that appropriate use is made of all available revenue streams.