TOPLINE Healthcare is a Centers for Medicare and Medicaid Services (CMS) recognized consulting and technology company with in-depth knowledge and experience providing innovative, proven, and lean solutions for complicated problems facing healthcare providers today. We specialize in clinical documentation, denials and appeals, provider education, efficient workflows, cyber-security, data management, growth revenues, and overall patient care improvement. As a trusted partner of CMS, we focus on keeping providers compliant and up-to-date with ever-changing rules and regulations while implementing solutions that improve their bottom line and support patient-centered care.
Our Mission is to improve the health of provider outcomes by innovating systems and technology that supports patient-centered care, which in turn improves the overall health of our nation.
Mark Kimmel, Ph.D., Co-Founding Partner
CEO | Director of Research & Development
Mark Kimmel has an extensive background in the healthcare industry and leadership with over 30 years of experience ranging from ICU nursing and medical missionary work to high-level hospital administration and FEMA incident command. With immense skills in developing strategies and processes to improve the healthcare system, Mark co-founded Topline Healthcare (TLHC), which he led in becoming a trusted partner of CMS that completed the first successful EMDI pilot that officially recognized TLHC's systems and processes. CMS continues in partnership with Mark and the TLHC team in helping providers to navigate successfully in today's everchanging world.
Susan A. Hemme, Co-Founding Partner
President | Director of Operations
With more than 25 years of experience in business ownership, development, operations, and project management, Susan brought her knowledge, resources, and belief in the success of providers in the healthcare industry during this pivotal time of change. She has been instrumental in the co-founding and building of Topline Healthcare while assisting in the development and implementation of Topline Healthcare's CMS endorsed Codeable LanguageTM software and system. This first-of-its-kind approved CMS pilot program was successfully completed in less than a year and has become the standard in which proceeding CMS pilot projects are to follow. As an expert in the field of project management, operations, organization, and written communication, Susan uses her skills to continue the dynamic growth of Topline Healthcare.
Oscar Mann, M.D., F.A.C.P., F.A.C.C., F.C.C.P.
Chief Medical Advisor
This highly accomplished award-winning physician joined forces with Topline Healthcare to ensure the success of provider efficacy and clinical validity. His achievements include serving as Clinical Professor Emeritus of Medicine, Georgetown University School of Medicine, a Fellow of the American College of Physicians, a Fellow of the American College of Cardiology and a Fellow of the American College of Chest Physicians, a Co-Founder of Foxhall Internists, P.C., a Former Chair, Georgetown University Medical Alumni Board, the recipient of the Georgetown University John Carroll Award, and the Georgetown University School of Medicine Founders Gold Medal Award. Dr. Mann is a critical force in helping providers to move forward into the world of successful clinical documentation. Author: A Journey of Hope
Sandra Lefevre, R.N., B.S.N., C.C.M.
Director of Clinical Appeals
Sandra Lefevre is well established in the healthcare industry with a substantial career spanning nearly 40 years as a Registered Nurse and Certified Case Manager. Along with her strong clinical background and elite healthcare management skills, Sandra has a proven record of overturning complex high dollar government and private payer denials at all levels of appeal. In addition, Sandra aligns with Topline Healthcare in providing physician and staff education to help providers reduce denials, increase approvals, maximize reimbursement profitability, advance Medicare compliance, and improve patient care.
Director of Project Management
Shaun Novak is an emerging technologies expert with over 20 years of experience developing, adapting, and integrating new technologies in areas of influence and service. Before bringing his executive-level skills and organizational talents to Topline Healthcare to help manage internal and hospital, commercial, and federal space projects, Shaun established and ran an emerging technologies group within Warner Brothers, where he brought together and led teams to collaborate and pioneer new production technologies. Shaun is masterful in simplifying and delivering information with a benevolent strength that helps improve the health of provider outcomes and satisfaction.
Reginald L. Brown
Sales and Marketing Advisor
Reginald "Reggie" Brown has over 40 years of management experience in sales and marketing in the federal, state and local governments, and healthcare markets. Prior to his current position as Sales and Marketing Advisor for Topline Healthcare, Reggie served as Director/Vice President of two Fortune 500 companies — Xerox and Oracle. Moreover, Reggie was appointed to the White House and served under two presidents on the President's Commission on Executive Exchange as an advisor to the Secretary of Defense. Throughout his career, Reggie has served and continues to serve on several corporate boards, and is a conduit for bringing CMS endorsed systems, services, and tools to help providers succeed in the never-ending changing healthcare climate today.
THE TOPLINE HEALTHCARE STORY
Topline Healthcare was formed to meet a growing need in the healthcare industry, which is to simplify payments and empower providers to adapt to the ever-changing guidelines set by Centers for Medicare and Medicaid Services (CMS). We serve the medical community, from hospitals and healthcare facilities nationwide to local physicians who treat those patients daily. Included in this community are organizations such as Medicare, Medicare providers, medical professionals, coders, Clinical Documentation Improvement Specialist, Case Management, and Chief Medical Officers.
After years of working with physicians and sharing their frustrations, understanding how documentation impacts not only the patient but also the facilities in which providers work, healthcare expert Mark Kimmel, Ph.D., envisioned creating a software program that would improve physician documentation, clinical validation, and patient outcomes. He began designing this program to help providers save time and money, thus increasing profits while reducing AR days and minimizing RAC audits.
In 2013, Kimmel then joined forces with a business strategist and owner of Hemco Publishing, Susan Hemme, to launch Topline Healthcare, help develop the software now known as Codeable LanguageTM, and to bring the system to providers in the most effective, efficient manner possible. In July of 2013, they launched the best-selling book Healthcare Providers' ULTIMATE GUIDE TO WIN, Even As Medicare Changes the Rules. As the industry-leading author-expert, Kimmel revealed the impact that changes in Medicare was having on the healthcare industry and how providers could stay ahead of those changes. Kimmel also accurately predicted upcoming trends and regulations that have since come true.
In 2014, Kimmel and Hemme successfully led and completed a pilot program for CMS, which proved the efficacy and interoperability of Topline Healthcare's system, processes and propriety software, Codeable LanguageTM. Under this program, Topline Healthcare’s pilot was the first of this kind to demonstrate a reduced claim submission error rate (from 54% to 1%). Their success resulted in Topline Healthcare becoming the first company ever to become CMS recognized and subsequently listed on the CMS Interoperability Proving Ground website – HealthIT.gov . Topline Healthcare continued to work with CMS on the forefront of changes and improvements in the healthcare system while collaborating with other companies and completing more pilots.
In 2015, Kimmel and Hemme partnered with nationally recognized business development expert, Jay Nussbaum, an entrepreneurial leader with a history of success in leading Fortune 500 companies. The addition of Nussbaum, with his experience at the forefront of change in technology, government, and healthcare, helped to bring Topline Healthcare's successful integration into the marketplace.
Kimmel, Hemme, and Nussbaum built a team of highly accomplished subject matter experts, advisors, and healthcare team leaders.
They further developed the end-to-end billing solution, known as H3 Solution used in the CMS pilot program, by partnering with two other leading-edge system/software companies, Adobe and Infor. This innovative solution fulfills the current government mandate for interoperability, which helps to simplify and expedite payments to providers. In consortium with Adobe and Infor,H3 Solution was
launched in October 2016 — New York [October 2016] article. Sadly, Nussbaum passed away on August 31, 2019. He continues to be warmly remembered and greatly appreciated for his friendship, leadership, and contribution to the growth of Topline Healthcare.
Topline Healthcare is currently based in the Washington D.C. Metropolitan area, well-positioned as a trusted partner with CMS, and continues expanding to help providers nationwide get ahead of the critical changes facing the healthcare industry today. With a dynamic focus on successful documentation and reimbursements, Topline Healthcare offers innovative leading-edge technology, systems, and services solutions so that providers are more efficient and profitable while advancing improvement in patient outcomes and overall health.