Services Offered

Coder CEUs and Training

• Customize a CEU approved program tailored for your staff, taught in your office.
• Complete coding/auditing training according to 1995/1997 E/M Guidelines, updates in CPT, ICD-9, HCPCS and Correct Coding Initiative.
• Coding policies including: Unbundling, Diagnosis Linkage, Medical Necessity, Modifiers and Incident-To.
• Training in use of Medical Audit Tool for E/M audits.

  PatientCare Enhancement
• Care Measures Service empowers the physicians and staff with an evidence-based system to measure patient outcomes.
• Care Notifications Service provides physicians and staff with notice of needed follow-up action, such as visits, lab tests, medication changes, etc based on the patient's individual profile.

  Provider Support
• OIG Workplan review as it applies to your practice with updates on CMS red-flag issues,
• Compatibility of ICD and CPT code integration, and maximized use of modifiers.
• 1995 /1997 E/M Guidelines review.
• Application of CMS documentation rules for inpatient/outpatient visits, physician office and the appropriate use of physician extenders and incident-to rules.
• Common pitfalls for diagnostic wording including use of "with", "secondary to" and "related to" and how these can directly effect reimbursement.
• Unbundling and Modifier updates.
• Level of Service E/M code benchmarking by specialty.

  Medical Records Coding and Auditin
• Review of documentation, substantiation of medical necessity and what is needed to achieve compliance.
• Validation of ICD-9-CM and CPT code integration, modifiers and accuracy of bills submitted.
• Auditing of medical records from the encounter form to the EOB to determine where your charge capture is detoured.
• Comparison of encounter forms with medical records to verify the presence of encounter data for all documented services. Review of encounter data for all documented diagnostic information.
• Comprehensive audit tools including: Medical Audit Tool Form 1995/1997 E/M Services, Provider Scorecard (weighted evaluation), E/M Utilization Analysis, and Internal Audit Program (data collection forms).
• Practical feedback of coding practices with steps to implement recommended improvements in medical record documentation and code selection.
• Comprehensive feedback focusing on audit results and areas of concern.