YES HIM Consulting, Inc. Your Consulting Firm for Auditing, Coding and Education

Revenue Cycle

Fiscal Year

End of The Fiscal Year Push!

By John Franz / December 31, 2019 / 0 Comments

Every organization associated with Health Information Coding has felt the pressure to catch everything up at the end of the Fiscal Year. It helps to understand what is at stake and how you can help. Some Fiscal Years (FY) correspond to the calendar year, while others start/end at times established for taxing and accounting purposes. Annual Financial reports are generated during this time to show the success or failure of the organization to meet its goals and expectations.

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Medicare Advantage

Medicare Advantage Insurers Use Reviews to Get Higher Payments

By YES HIM Consulting / December 20, 2019 / 0 Comments

An investigation by the Office of Inspector General (OIG) revealed Medicare Advantage insurers might be overstating patients’ diagnoses without the proper documentation to receive larger payments. Based on the 2016 Medicare Advantage encounter data analyzed by the OIG, insurers were able to get an extra $6.7 billion in payments in 2017.

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strategic planning

Crafting Your Organization’s Strategic Plan For A Successful Year

By YES HIM Consulting / December 18, 2019 / 0 Comments

The healthcare and health information management industry is no stranger to constant changes and evolutions. To successfully navigate the future – and be prepared for anything – healthcare organizations need to craft a strategic plan. A strategic plan is beneficial for everyone: It allows the company owner to identify which goals will help grow the organization, and it helps the employees foster that growth by accomplishing the necessary objectives and increasing productivity.

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Coding compliance

Should Secondary Medical Conditions Be Coded?

By YES HIM Consulting / November 18, 2019 / 0 Comments

Locating causes for denied claims can be a tricky process because staff is accustomed to assigning ICD-10-CM diagnosis codes based on the provider’s one major diagnosis documented in the medical record and assume the coding is correct if there isn’t a difference.  However, the lack of support for necessity of the bill might not be as obvious.

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Revenue Cycle Management

Clinical Documentation Integrity Significance in Revenue Cycle Management Success in Healthcare

By Mari Cely / November 6, 2019 / 0 Comments

Perhaps the most vulnerable of issues in the Revenue Cycle Management process is the potential for incorrect information creation in a patient’s chart. Data disparities duplicate or inaccurate medical record number recording, and unverified insurance verifications processes in place can potentiate claim denials. Revenue Cycle Management can be thought of as the method of transportation to take an organization from one place to where it needs to go. For the transport to occur successfully and be operationally sound, the processes in place to support it must be accurate and deliberate.

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Revenue Cycle Management

Revenue Cycle Management 101: Impact of ICD-10 Coding in Inpatient RCM

By YES HIM Consulting / July 7, 2019 / 0 Comments

A brief overview of how ICD-10 coding can impact in various stages within the revenue cycle management process including key aspects in which ICD-10 coding can improve DNFB.

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Value Based Care

Value-Based Care: Trends and Challenges in Revenue Cycle Management

By Mari Cely / April 3, 2019 / 0 Comments

The effectiveness of value-based care models is measured based on how this type of reimbursement can improve the quality of a patient’s overall health. Reducing hospital readmissions and improvement in preventive care are good examples of critical factors to assess the effectiveness of these models. U.S. legislation is clearly moving towards the adoption of value-based care models.

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Revenue impact

Revenue decline moving faster than Not-for-profit hospitals’ cost reductions

By Elizabeth Kelly / October 12, 2018 / 0 Comments

Analysts share alarming facts about revenue trends in the past couple of years; the growth in expense reduction is slower than revenue decline. This is affecting Not-for-profit hospitals tremendously.

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Query programs backed by data

Case Study: To Query or Not to Query…

By JJ Crumbley / October 12, 2018 / 0 Comments

Across healthcare, the majority of hospitals or healthcare systems have incorporated query programs; however in many cases they are driven solely from a compliance perspective. We’ve prepared a case study using data gathered over the past couple of years, in order to reach an undeniable conclusion: it’s not about the why, it’s about the how.

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YES CDIS: Liaison between CDI and Coding

By Amy Davis / July 23, 2018 / 0 Comments

The role of the YES Clinical Documentation Improvement (CDI) Specialist is to be a liaison and a partner, to compare the facility CDIS Medicare severity diagnosis-related group (MS-DRG) to the facility coder MS-DRG when there is a mismatch between the two MS-DRGs.

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YES HIM Consulting, Inc. Largo, Fl.
Office: (727) 531-3839       Fax: (727) 240-4592