DNA MEDSOLUTIONS, LLC℠

Founder|President

MedXPrime

Pharmacogene Rx,  Business Medical Advisors,  Revenue Integrity Consultant

Business Economics Advisors|FWA Prevention|Healthcare Economics Optimization 

PHYSICIANS OF WINTER HAVEN, LLC

Busines Economics/Healthcare Law Compliance and Operations Management/Healthcare Economics Executive

Lakeland Regional Health-Florida

Revenue Integrity Management and Development 

Bond Clinic P.A.

Develops and executes provider comprehensive educational opportunities/curriculums (coding resources, materials, tools, webinars, campaigns.) based on audit results, noted trends & changes within coding compliance and regulatory guidelines, while supporting organizational compliance models. Leads provider‘s education events to discuss overall audit results overview, identifying trends and action plans. Provides support or project management for any other related audit and coding initiatives and assist in other related responsibilities as required by executive leadership team. Establishes positive working relationships as the subject matter expert with all parties to provide input on risk and ensure a sustained understanding of federal coding and billing compliance requirements.

Ambulatory Pro-Fee Revenue Cycle Specialist 

AdventHealth West Florida

Perform comprehensive audits of healthcare payer processes, policies, and claims to ensure adherence to regulatory guidelines and contractual agreements. Review and analyze medical records, claims data, and billing documentation to identify coding errors, improper payments, and potential fraudulent activities. Conduct in-depth investigations of identified issues, collaborating with internal departments and external stakeholders as necessary, to determine root causes and implement corrective actions. Develop and maintain audit protocols, checklists, and documentation to ensure consistent and accurate auditing practices.Stay up-to-date with industry regulations, coding guidelines, and reimbursement methodologies to ensure compliance and provide accurate interpretations during audits.
Generate detailed audit reports, including findings, recommendations, and action plans, and present them to management and relevant stakeholders. Collaborates with other internal departments to ensure that audited requests receive the proper actions moving forward
Perform data entry and record update statuses of audits throughout the resolution process.  Meet or exceed departmental metrics and productivity standards as given by leadership.

Revenue Integrity Specialist 

Westerbank

 Compliance Audit Manager

Founder & President of DNA MEDSOLUTIONS, LLC℠ With over 19 years of healthcare experience, We developed a core of competencies in process improvement, healthcare law, compliance and privacy policies, FWA investigations, revenue integrity, cost savings programs, ASCs value-based contracts, integration of support systems, clinical documentation improvement, credentialing, managed care contracts healthcare economics optimization analytics and Real Estate inclusive notarization 

Our mission is to help healthcare organizations by improving their performance, quality, and profitability by analyzing FWA utilizing effective Augmented Intelligence technology through all organizational systems. We assist in developing ASCs business opportunities. We are committed to maintain a successful work environment for employees, clients and peers. We are certified in workplace harassment and bullying prevention. We have a team dedicated to RCM and healthcare value-based strategies. Fluent in Spanish and English. My background is supported by a Master's in Criminal Justice and Law Enforcement Administration, Bachelor's in Political Science and Government Affairs.

Service Line Description

Our service line delivers integrated solutions that enhance healthcare delivery, mitigate risks, and drive sustainable growth. By harnessing the power of healthcare economics, augmented intelligence, and industry expertise, we optimize operations, safeguard patient safety, and protect organizational assets.

Core service areas include:

Healthcare Economics Optimization: We employ advanced analytical techniques to improve financial performance, optimize resource allocation, and develop sustainable business models.

Safety and Quality Improvement: Through the application of augmented intelligence and evidence-based practices, we help clients enhance patient outcomes, reduce medical errors, and achieve regulatory compliance.

Workforce Protection: We focus on talent management, employee well-being, and occupational safety to build high-performing and resilient workforces.

Fraud, Waste, and Abuse Prevention: Our specialized team employs data-driven investigations and advanced analytics to detect and prevent fraudulent activities, safeguarding organizational assets and reputation.

Antitrust Compliance: We provide strategic counsel and support to ensure adherence to complex antitrust regulations, mitigating legal and financial risks.

Our integrated approach enables healthcare organizations to address complex challenges, achieve operational excellence, and deliver exceptional patient care.

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Armando Javier Colón Aponte MSCJ, CBMA, COC, CASCC, CPPM,CFWAP, CWHBP, PCAP™

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Armando Javier Colón Aponte MSCJ, CBMA, COC, CASCC, CPPM,CFWAP, CWHBP, PCAP™'s Linkedin Analytics