Our expertise across the Health Information Management continuum affords us the ability and resources to provide comprehensive consulting services to facilities around the country. Our consulting services are designed to assist our clients with critical areas of coding and billing, including:

  • Inpatient, Outpatient and ED Coding Audits
  • Comprehensive RAC preparation including test audits and subsequent plan to get you on the right track
  • Denial Management
  • Chargemaster Review (limited to ED)
  • Coding and Documentation Education
  • Concurrent Analysis of Billing Processes and identification of cycle impediments
  • Large-Scale Medical Record Scanning, Paper-Electronic Format (Production and Consulting basis)

cservOur client services team has one responsibility: keep the client happy. They handle the training of on-site clerical personnel, and they act as liaisons between your facility and the rest of HCCS. They are available anytime to answer questions, address client concerns, and assist clients in any other way they can. Regardless of where your facility is located, HCCS client services is close at hand. They have proven very effective problem solvers, and have a superb track record of averting even the most certain disasters in HIM departments.

 

HCCS offers coding audits that are designed to give you an accurate picture where your facility stands in regards to all facets of coding accuracy. Now more than ever it is critical to identify and subsequently rectify coding errors before your errors are discovered by someone like a RAC.

 

 

The sample of the ED audit includes:

  • Verification of ED level of service assigned for facility services
  • Verification of ED level of service assigned for physician services, if applicable
  • Verification and identification of all procedures performed and reportable by ED facility and/or physician staff
  • Verification of ICD-9 Diagnosis code assignment, including Principal and Secondary Diagnoses
  • Coding and Documentation Education
  • Verification of coding for medical necessity

Based on the audit results, information is presented to provide:

  • Average level of service as coded by your facility, both facility and professional
  • Average level of service as coded by HCCS, both facility and professional
  • Average charge per patient as billed by your facility
  • Average charge per patient if HCCS had coded the ED charts
  • Analysis of documentation practices
  • Analysis of coding, both ICD-9 and CPT-4
  • Appropriate use of modifiers
  • Comprehensive comparative analysis of facility and professional charges
  • Financial analysis of facility coding compared to HCCS Coding
  • Analysis of facility billing practices, including price structure

These errors are much more common than many believe and the presence of any one of them can be too much to ignore from a compliance standpoint and is indicative of undercoding that can amount to tens, if not hundreds, of thousands of dollars in lost revenue each year.

Finding a few hundred thousand dollars in entirely legitimate, yet unrealized revenue at a facility is a discovery of these audits that is not at all rare. This is the product of accurate coding, and is why our company standard of 95% accuracy is so important.

Data Collection, Analysis, and Reporting

The benefits provided by the organizational awareness that comes from increased measurability and accountability can be substantial. In addition to reporting essentials such as turnaround time and accuracy, our Client Services team can provide clients with valuable information using whatever data they have access to. For clients utilizing our CodeMed™ software, actionable feedback is particularly easy for us to compile. For all other clients, as little as a few detailed, single-day DNFB reports is more than enough to provide us with what we need to diagnose billing inefficiencies.

While a typical hospital might have difficulty pinpointing the roots of problems like cash-flow holdups, HCCS can quickly locate impediments to the billing cycle such as MDs with bad documentation, slow departments and sites, and even days of the week that need extra attention. For example, if Dr. X tends to omit his op reports every Friday that he is at Facility A, Client Services will tell you about it. Significant findings are shared as soon as they are uncovered and summaries compiled as needed for scheduled meetings.

  • We know that in life placing blame is not always the best course of action, but when it comes to the business world and concerns things like bottlenecks in your hospital's billing cycle we feel that it's important to know where improvements should be made.

  • "Exactly which days are hurting us the most and is our team doing anything to improve this?" The Trend of the numerous factors affecting your billing cycle are just a small portion of the reports provided to your facility on a regular basis.

  • Not only can we identify impediments like the specific physicians that hold up your billing, we will also tell you what it is that they are doing wrong so that it can be corrected.