Welcome to a holistic approach to healthcare processes.

ASK FOR A DEMO: UTILIZATION MANAGEMENT 360®

John Zelem, MD, FACS is principal owner and chief executive officer of Streamline Solutions Consulting, Inc. The company provides technology-enabled, expert physician advisor services.

Dr. Zelem is focused on managing Medicare and Medicaid regulatory compliance, minimizing inappropriate medical necessity denials and achieving appropriate lengths of stay in acute care hospitals and health systems. Read More

Get Free Email Updates!

Signup now and join the many who will receive an email for updates, new events, and new content.

I will never give away, trade or sell your email address. You can unsubscribe at any time.

Services

Streamline Consulting Services, Inc. helps hospitals, physicians, utilization review and physician advisors by providing a holistic solution to successfully achieving a healthy and compliant process in your revenue cycle.

Read More

Taking the holistic approach

Looking at the big picture

Every little change you make affects the whole.

Utilization Management 360®
Breaking Down Silos

Read More

Physician Advisory Services

The use of Physician Advisors has been increasing exponentially over the past years. Streamline Solutions Consulting, Inc. understands the history, development, utilization of the Physician Advisor role for more than just chart reviews for Level of Care Determinations, and can:

  • Analyze your present program for compliance, standardization, and accountability
  • Ensuring that existing and new program Physician Advisors integrate with UR/Case Management, your physicians, and your leadership
  • Through gap analysis techniques evaluate for efficiencies
  • Help “break down silos” that may exist linking Utilization Review, Case Management, and CDI in a holistic manner
  • Improving physician documentation
  • Help to develop and customize new programs for your individual needs unique to your culture and community
  • Assist in hiring and training competent Physician Advisors for new programs through a unique onsite training presence and mentoring afterwards
Read More

Testimonial

August 21, 2020

Re: Testimonial for Services of Streamline Solutions Consulting, Inc.

The Sentara Revenue Cycle engaged the services of Streamline Solutions Consulting, Inc., specifically Dr. John Zelem, for an independent review of the Utilization Review processes for Sentara Healthcare.   I have been acquainted with Dr. Zelem since the beginning of our business relationship in 2011 with Optum in his prior role as Regional Vice President of Provider Relations and Education.

In this time, I have come to value his experience, professionalism, and wealth of knowledge in the development of best practice programs related to utilization review, physician documentation, and regulatory compliance. We have built a trusting and collaborative relationship over the years which made the selection of John for our project an obvious choice. Read More

If you have further questions, I would be happy to assist you.

Sincerely,
Karen A. Pelham, MSN, RN
Director, Hospital Clinical Revenue Cycle
Sentara Healthcare
kapelham@sentara.com
757-965-0372

White Papers

  • (0)

    The clinical revenue cycle (CRC) is seldom mentioned and under-reported. The more universally recognized concept, of course, is revenue cycle management (RCM). It is the umbrella of which CRC is an integral part and a crucial revenue driver, accounting for a large portion of the direct and indirect cost of providing care. CRC needs to be recognized for this importance, and also requires improvement from its present status with a more holistic approach.

  • (0)

    When we hear the word hospital or healthcare our thoughts automatically go to patient care which is not unreasonable. Yet, one must remember that there is also a business side to healthcare. If it is not treated as a business there will not be enough revenue to fund it for survival. Learn more…

  • (0)

    The role that the Physician Advisor provides as communicator, facilitator, subject matter expert, and “quarterback” is invaluable. In just performing their intended duties, working with teams and management, managing the silos within Clinical Revenue Cycle can occur.

  • (0)

    It seems that there is now a relatively new concept or program that has come into play in healthcare and it is called “Revenue Integrity” (RI). Is it another silo or is it a solution for clinical revenue cycle? According to an HFMA Survey of 125 hospital and health system CFOs and revenue executives, only 44 percent of respondents say their organizations have established revenue integrity programs.

  • (0)

    Team empowerment is the essential ingredient to the success of any initiative, but it cannot be engaged without thoughtful processes. Teams are composed of individuals with unique skills, personalities, backgrounds, and drive. Utilizing the ingredients provide here will help provide the cement, the glue, the structure to maintain an holistic approach where the whole is greater than the sum of its parts

  • (0)

    Making the Case for Utilization Management 360®. Read how UM360 played a role in a multi-hospital system and will continue to improve Clinical Revenue Cycle Management.

  • (0)

    Hospital revenue is declining. What kind of changes does Revenue Cycle Management need to make? What is the solution? The real question to ask is how much pain needs to be endured for RCM to be motivated to change and not just use temporary patches. What will be the precipitating factor that will cause RCM to make some changes now before significant pain. The solution is “Utilization Management 360®”