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Paula M. Hall, LVN,RMC,CPC-C,CPC-H,CH

First Practice
Management Consulting

Contact Information:

Dubai, UAE
Dubai, TX 58104
United Arab Emirates
T: 971567379028
www.firstpractice.co

Years in Business:

 

40

Clients I'm Seeking:

 

Healthcare Revenue Management, Physicians, Medical Billing Companies, Hospitals and Clinics, Healthcare Facilities as a Whole.

About My Business:

 

Paula M. Hall, ABA, AHA LVN, RMC, CPC-C, CPC-H, PMCC, CHE, PMC, CBCS, CPAR/CPAT, CHCO Co-Founder, GM- COO of First Practice Medical Billing and Practice Management Company CME/CE- Facilitator and Training Instructor Six Sigma-Green Belt Lean Six Sigma - Healthcare EXECUTIVE PROFILE: • Over 40 + years of experience covering the entire spectrum of the Healthcare Industry. Domestic and Internationally. • Setup, Implementation and Management of Clinics and Hospitals • Extensive background in nursing covering Multiple Specialties. • Provider of Healthcare Consultancy Services across 49 States in the USA. • Medicare/Medicaid and Commercial Insurance Specialist. • HIPAA, Confidentiality and Compliance Certified Specialist. • Management Consultant-Healthcare Exchange Implementation • Quality Care, Control and Assurance Specialist-JCAHO-USA • International Project Managing Director for a Fortune 500 Durable Medical Equipment Company from USA to India. • Implementation and Management-3 Healthcare Divisions-India. • Implementation and Management-2 Healthcare Divisions-Philippines. • Training and Certification-Medical Admin Staff and Nurses in Continuing Education. • Clinical Documentation Implementation and Training • Medical Coding Training in ICD-9 & ICD-10-CM, CPT and PCS • ICD-10-AM, ACHI and ACS Clinical Coding – 2014 • JCIA Implementation Senior Project Manager-Dammam, Saudi Arabia - 2014 Paula launched her Healthcare Career as a Nurse in the USA, from 1979 working with many facilities and covering multiple specialties. She started her extensive career as a Nurse in the United States working in some of the most well-known Hospitals and Clinics in Texas, from the Emergency Room and Trauma center, to Surgery, Neurology to Podiatry along with many Rehabilitation facilities. Upon completion of her Nursing Career, she branched into the Admin side of the Healthcare Domain, starting with Medical Billing/Coding and worked her way up to a level of Consultancy. She was able to travel to 49 States in the USA to work with different Healthcare Providers and Insurance Carriers. She worked on some of the very first RMC Projects and implemented the IT side for Exchanges and Clearinghouses. She acquired so much extensive experience in multiple areas and was contracted to Project Manage the very first Outsourced (Healthcare) Project to India. Even after the Project concluded successfully, she remained in India for the next 8 years to set up many Healthcare Divisions for local Entities. In 2007, after here projects in India were complete, she was contracted to the Philippines and spent the next 3 years Training and Certifying the very first Medical Billers/Coders, first in Bacolod, then on to Manila and Baguio. In 2010 she was contracted to train the first Medical Biller/Coders in West Africa. All training, skill sets, and expertise and management capabilities were acquired in the USA. As of March, 2011 to August, 2012, she has completed Consultancy Contracts in the United Arab Emirates, Saudi Arabia and Kuwait. (Services included all aspects of Healthcare Revenue Management and Education). She remains in the UAE and Kuwait providing Physician Clinical Documentation, CME Training and Nursing Continuing Education along with Workshops and Seminars to Healthcare Providers-Hospitals/Clinics. January, 2013, she became Co-Owner of First Practice in the UAE which is the first Practice Management Company to cater to all the needs of facilities in the MENA and USA Regions. As of May, 2013 – Completed Training and Certification in Physio-Therapy Diathermy. She also completed a Certification to Train and is the Middle East Agent of Sixtus- Italy. June, 2013 – completed training in Lean Six Sigma Healthcare. HR Human Resources and Recruiting Capabilities: Throughout her career Paula Hall has assisted many facilities in many countries in staffing resources and preparing them for multiple projects. Throughout multiple companies, some of her major tasks were to handle the HR responsibilities of Americans and the descendants of countries such as India, Philippines, and West Africa. She is currently seeking opportunities for Staffing in the Middle East due to the dire need for Healthcare Personnel. She has the capabilities to plan, direct, manage and oversee the activities and operations of the Human Resources and Recruiting, including Staff selection, classification and compensation, employee and labor relations, personnel records, risk management, worker’s compensation, insurance, employee/organizational development, diversity, affirmative action and to coordinate assigned activities with other departments, divisions and outside agencies; and to provide highly responsible and complex administrative support to any of the companies she has been contracted to perform these services. Quality Assessment, Implementation and Management Capabilities: Paula Hall has been assigned to multiple designations throughout her career. During the design and implementation of multiple systems in Healthcare Facilities in the USA, she tapped into the Quality Assessment and Quality Standards design and implementation along with on-going management. In the late years of the 1980's the USA transitioned into JCAHO, which is the Joint Commission on Accreditation of Healthcare Organizations. During this time, as a Nurse, she was in charge of implementing Quality Standards, SOP's, Policy and Procedures, Nursing Protocols, and Patient Safety Measures along with Operational Standards and Measurements. She has transitioned over the years into more areas of Quality Standardization Techniques including, Measurements, Benchmarking, and Utilization Reviews. She also became a JCAHO Surveyor working with a team of individuals that all traveled to Healthcare Facilities to evaluate Operations, Practices and Performance, through sourcing from Consultancy Agencies in the USA. Brief Synopsis of Experience in Medical Coding Quality Management: • Performed audits of medical records to ensure all assigned ICD-9 codes were accurate and supported by written clinical documentation. • Provider of education to internal staff and external providers based on audit findings. Provided general education on ICD-9 codes as appropriate. • Effectively communicated the audit process and results to the appropriate departments and management. • Assisted the senior level staff in providing recommendations for process improvement so that productivity and quality goals can be met or exceeded and operational efficiency and financial accuracy can be achieved. Brief Synopsis of Current Experience in Hospital and Clinic Quality Management: • Ability to working with a Healthcare facility with its staff to provide a smooth implementation of Quality Management framework and maintenance. Identification/ review and analysis of compliance reports/ risk management/, health checks and performance management. Participation in meetings with Department Heads and Staff to prepare annual plans for quality management, patient safety and risk management and their prompt implementation. • Management of operational aspects in healthcare services rendered with the aim and focus on achieving excellence in quality / cost and performance management in accordance with the HOSPITAL-HEALTHCARE FACILITY group strategy, mission and values. • Ensure professional Admission, Intake, Patient Management and Coding/Billing functions. • Managing clinical governance, healthcare risk management and ensuring implementation of quality improvement tools to enhance hospital performance measures and safeguard national and international patient safety measures. • Collection of patient demographic details/ accurate eligibility details and entered into the system as per HOSPITAL-HEALTHCARE FACILITY standards. Patients scheduled according to doctors’ availability and as per HOSPITAL-HEALTHCARE FACILITY standards. No shows contacted and rescheduled where applicable. Doctors’ appointment calendar created and updated. Assistance in planning and implementing key quality initiatives. • Thorough knowledge and implementation of guidelines from regulatory body (JCIA) Joint Commission International Association. Knowledge of healthcare guidelines from Governing Body of the Country. i.e. Dubai Health Authority, and Health Authority of Abu Dhabi and Dubai Health Care City. • Ensure teamwork and maintenance through creating a good rapport with Physicians, Nurses, Departmental and Support Staff involved in the process. • Clinical Documentation Training and Implementation for Physicians, mainly Outpatient setting, but workshops in Hospitals setting as well RECENT PROJECT ACCOMPLISHMENTS: 2013 – Management Consultant for a Clinic in DHCC (Dubai Health Care City) in Clinical Quality Management acquiring the CPQ Accreditation. 2013-2014 – Management Consultant for a Clinic in Dubai. Complete Clinic Reconstruction exterior/interior. Nursing Training, Insurance Contract Negotiations and Management, Physician Documentation Training and Management, Quality Patient Standards Implementation. Management of Clinic/Insurance Tariff. Implementation of Clinic Management IT System. 2013- 2014 – Contracted by MOH in Saudi Arabia to prepare for JCI Accreditation. Preparation of 425 Bed Hospital and multiple Departments and Polyclinics. Improvement of Quality Standards to improvement of Patient Safety and Care to preparation of Policies and Procedures, Nursing Protocols and Medical Records Department reconstructions and Medical Files design. JCI Accreditation was acquired. 2014 – Contracted by Hospital Group in UAE to leverage the healthcare facilities in Best Practices and International Standards. 2014 – Contracted by Healthcare Consultancy Company in the USA to launch very first Medical Coding Project in the UAE. 2015 – Contracted by Multiple Clinics in Dubai and Abu Dhabi for Clinic Structuring and Re-structuring. 2016 – Contracted by Clinics in Jeddah for (7) Clinics reconstruction along with Pharmacies, and Pharmacy Warehouse Supply Chain Management. 2016 – Contracted by Organization in Malaysia to head Training Conference on Healthcare Finance Excellence and Healthcare Management. 2016 – Consultant for management of a Healthcare Conference in Togo. 2017 – Contracted to Angels of Medical Care Home Care Facility for project in Facility Reconstruction. 2017 – Currently on a Project in Kuwait for Hospital Reconstruction with focus on EMR Enhancement and Clinical Documentation Enhancement. Implementation of CDI Program in the Hospital ADDITIONAL ROLES AND EXPERIENCE: MEDICAL CODING: As a healthcare consultant, she was able to save multiple hospitals millions of dollars by helping them understand Medical Coding and the Revenue Cycle; how to correctly bill claims and ensure proper reimbursement. She also has experience in Revenue Management, Operations Improvement, and Compliance. • Pioneer in launching the first Healthcare BPO / KPO in India • Pioneer in setting up Hospital Coding & AR services • Holder of 18 Credentials in Medical Coding, Billing, Compliance, and Training EMR – EHR (Electronic Medical/Health Record): Participated in revenue cycle projects under the direction of outside consulting firms focused on process re-engineering of EMR with HIM focus, to increase the healthcare facilities revenue by streamlining its workflow reducing the number of unbilled and denied accounts. Her experience includes but is not limited to: Enterprise scheduling Clean claim checks Task management Audit trail & Access control KPI Dashboards Data mining reports Electronic data interchange (EDI) Workflow Process Implementation and Management Denials Management (Trending and Benchmarking) CLINICAL DOCUMENTATION PROGRAM – IMPLEMENTATION AND TRAINING Provider of clinical evaluation of the medical record to facilitate capture of comprehensive medical record information to reflect clinical treatment, decisions, and diagnoses for inpatients. Communicates with physicians and others to obtain appropriate information. Provides or coordinates education to internal customers and acts as consultant to coders. Gathering and analyzing of information pertinent to documentation findings and outcomes for reporting structures. Ability to Structure and Implement Programs for Hospitals and Clinics on Clinical Documentation with focus on Quality Standards. FRAUD and RISK MANAGEMENT - IMPLEMENTATION Ms. Hall was trained to work with one of the first Fraud and Investigation (Healthcare) Units in the USA hired by Medicare Regional Division in South Texas. Duties included: • Developed and implemented plans for prospective and retrospective fraud, waste and abuse (FWA) avoidance, detection, investigation, and recovery. • She managed the day-to-day activities of assigned investigative analysts/investigators and assigned cases to staff based on skills and resources to ensure appropriate prioritization of cases; fostering a collegial and positive work environment; managing, mentoring, and directing individual and team performance; monitoring progress with individual and team performance goals. • Monitors compliance with company policies and procedures and compliance with pertinent FWA provisions of state contracts. • Assisted in development and presentation of FWA training processes.

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