Coding Compliance

due diligence

What to Expect in Due Diligence Audits & How to Find the Right Auditing Vendor

By Vanessa Youmans / October 26, 2023 /

The healthcare industry sees hundreds of facility acquisitions and mergers every year (PwC, 2020). A critical part of mergers and acquisitions is the due diligence process, which provides a complete financial and performance picture of a healthcare organization to ensure it is a sound investment. Every aspect of the facility, including the physicians, coding, property, finances, and more, are reviewed. In addition, M&A due diligence audits highlight potential liabilities and coding quality issues.

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coding productivity benchmarks

What’s the Next Step After Onboarding New Coders? Your Guide to Measure Coding Quality & Productivity Benchmarks of a New Hire

By Vanessa Youmans / September 18, 2023 /

The onboarding process is a critical phase that sets the tone for an employee’s journey within an organization. However, what comes next is equally important: measuring the coding quality and productivity benchmarks of new hires.

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clinical documentation improvement

Try These Coding Compliance Strategies for Your Organization’s Clinical Documentation Improvement & Bottom Line

By YES HIM Consulting / September 14, 2023 /

Healthcare organizations need to put the focus back on medical coding compliance and offer their teams effective strategies to get coding inaccuracies and inefficient claims management under control. Here are several coding compliance strategies to try this quarter for your organization’s clinical documentation improvement and bottom line.

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medical auditing

The Synergy of Medical Auditing: A Win-Win for Patients and Providers

By YES HIM Consulting / September 13, 2023 /

While most providers are hesitant to complete regular medical coding audits, it’s important to remember that they ensure accuracy and efficiency are maintained throughout the patient-provider relationship.

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empower team for coding audit

How to Empower a Medical Coding Team During an Audit

By Elizabeth Kelly / August 17, 2023 /

There are myriad benefits to performing regular medical coding compliance audits. In order to have a successful audit process, coders must feel like their voices are heard. We’ve compiled these strategies to help empower the coding team during the next audit.

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coding reimbursement specialist

Why is Revenue Cycle Management Important in Healthcare? Your Guide to Ensuring Profitable Medical Coding Reimbursements

By YES HIM Consulting / June 8, 2023 /

Healthcare organizations must enact steps to manage the revenue cycle process effectively and efficiently. Thankfully, there are revenue cycle management (RCM) systems and coding reimbursement specialists that rely on data analytics to help streamline the process.

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Everything You Need to Know About Claims Denials: Causes, Prevention, ANSI Codes & More

By Vanessa Youmans / May 4, 2023 /

ED claims denials are a common occurrence in medical facility coding and billing when the payers (or insurance providers) deny a claim for reimbursement. This article dives into the most common causes for these denials, how to prevent them with denial management services, and related topics, such as ANSI codes and the definitions of appeal versus rebill.

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severe malnutrition icd 10

Case Study: From Misreporting to Compliance: How Hospitals Can Implement a Standardized Process for Severe Malnutrition ICD 10 Diagnosis Codes

By YES HIM Consulting / March 20, 2023 /

Given that severe malnutrition MCCs increase the dollar amount in Medicare reimbursements, overcoding is a potential risk for all healthcare organizations. Review our recent case study findings where we present compliance, standardization, and improvement opportunities to one client hospital.

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healthcare coding audits

Healthcare Coding Audits Checklist: Prepare for a Successful Audit

By Elizabeth Kelly / March 20, 2023 /

Regular healthcare coding audits are necessary to run a compliant, successful healthcare organization. While the reason for the audit may differ, the overall checklist for conducting a successful audit remains relatively the same.

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What Factors & Scenarios Trigger a HIPAA Audit?

By YES HIM Consulting / March 16, 2023 /

The OCR performs a HIPAA compliance audit to confirm that covered entities and business associates protect and properly utilize PHI. Here are the factors and scenarios that trigger an audit.

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