Expert procedure documentation and coding has a major impact on the revenue cycle
Procedure coding and documentation have perhaps the greatest impact of any element in a healthcare organization’s revenue cycle. Correct, accurate and efficient coding can accelerate the billing cycle, decrease returned and denied claims and increase revenues. The opposite is also true. Poorly executed coding based on problematic clinical documentation can lead to undercoding, denied claims, and compliance issues.
It takes superior, qualified coders to produce clean claims
The highly qualified coding team at EqualizeRCM are AAPC/AHIMA certified coders who provide solutions to common coding problems to prevent human error, handle complex documentation, prevent denials, and ensure that fees and services match each other.
Outsourced coding with a focus on exceptional performance
When you need qualified medical coding and billing assistance, it makes a major difference who you choose. Where internal resources are stretched, outsourcing can increase your revenues and decrease expenses. Choosing the ERCM coding team reduces the risk from improper coding, and the result is improved cash flow and risk scoring. Reimbursement goes up and worries go down. Everyone gets to stick to what they do best.
Let our team partner with your team
Our viewpoint is the old adage: “What gets measured gets done.” Practices and their providers benefit greatly by consistent, regular feedback. Doing the analysis once a year or even once a quarter is a good start. Performing it regularly increases the likelihood of changing behavior. We suggest that you deliver this feedback through four different elements:
- Two Code Reviews—by CPC-certified coders
- Two Coding Reports—analytical comparison reports of E&M coding norms
- On-site (or by phone) Coaching—for providers that especially need or want it
- Peer code reviews (conducted by the “best” performing providers)
EqualizeRCM can provide Code Reviews, Coding Reports and On-site (or by phone) Coaching services to providers on an as-needed basis.
To perform the Code Reviews, we will:
- Select a random set of 25 charts per provider
- Our CPC-certified coders will code these charts
- Our team will then compare our coding to that of your coders and provide an explanation of any differences
- We will perform this work prior to the encounters being billed
- The results will be summarized by provider in a highly useful learning format
- The reports will be shared with you for distribution to the providers
- The provider will then be given the opportunity to discuss the results of the audit with the coder through the phone/email.
To produce the Coding Report, we will:
- Take line-item reports from the billing system (with your assistance)
- Analyze for each provider
- Analyze for major E&M groupings by level
- Present each provider’s individual data in a report showing his/her prior months and norms for comparison.
Through these tools, both you and the provider can see how the coding patterns are changing with time as well as feel assured that he/she is not over-coding or improperly documenting.
We expect this feedback loop to achieve the following:
- Providers will question, learn and change their coding practices as they gain confidence in their documentation and appropriate coding norms;
- Help reverse any the significant revenue loss currently occurring due to complacent or incorrect coding;
- Provide compliance and education support by helping to ensure your providers and your coders are properly documenting and properly selecting levels in line with documentation.
We can also provide On-site (or by phone) Coaching to your providers—or we can provide support to an on-site coach of your choice. Our CPC-certified coder would travel to your site(s) to hold a series of workshops in 1-2 days. Generally, these are in small group formats but can also be one-on-one training. We recommend performing the analysis and audits to see what trends and changes occur through that process—which will also provide significant learning. Then use the findings of those audits plus concerns of specific providers to decide whether and how to deliver the personal coaching. To learn more, use the below form to contact us.