Coding Audit Data Analysis is Key to Pinpointing Revenue-Killers

Coding Audit Data Analysis is Key to Pinpointing Revenue-Killers

With recent global events causing hospital systems to improve their operations and processes, decision-makers need skilled consultants to help them manage the evolution. Qualified HIM consultants, such as those at YES HIM Consulting, assist hospital management by analyzing coding audit data and recommending actionable solutions to pinpoint revenue-killers in the organization.

But why is data analysis an essential step in boosting revenue?

Because data analysis is the driving force of continuous quality improvement and ensures the organization meets its desired goals. Data analysis identifies coding errors, missing codes, discharged, not final billed (DNFB), and other factors that bring down revenue. And, just as collecting data is an ongoing process, so is data analysis.

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In an interview with For The Record magazine, YES President and CEO Karen Youmans spoke about the importance of data analysis and why current HIM directors need to have those skills.

“You always have the CFO concerned with the discharge, not final billed (DNFB) balance—when a provider has discharged a patient, but the facility hasn’t submitted a final bill,” Youmans said in the interview. “It’s one of the biggest revenue killers for health care providers. The number of skilled coders that you can contract with has become fewer over time. So, there is always a concern about the number of coders vs. quality and accuracy vs. productivity.”

“The DNFB is also about analysis,” Youmans explained in the interview. “An HIM director, then, needs analytical skills. If the CFO asks why the DNFB is so high, go back and show the monthly/quarterly trends. A one-time snapshot is not the true picture. It’s a marathon, not a sprint. HIM directors have to be able to analyze trends, not a one-time fix. They need to go back to the CFO and say, ‘Here’s where we’re going; yes, today we’re high, but look at the trend.’ Being able to convey that is important.”

For those HIM directors who do not have time or need an extra set of eyes to examine the data, YES is ready to step in and deliver strategies to get revenue back on track.

Our Coding Audit Data Analysis & Auditing Services

Our data analysis and auditing services include:

  • Trending reports
  • Query trending and analysis
  • Custom project management
  • IP/OP/ER/Profee cases; Customized Audits available per request
  • Quality Audits on a Monthly, Qrtly Annual, or Ad Hoc basis
  • Verification of ICD-10-CM Diagnosis Code assignment, including Principal and Secondary Diagnoses
  • Verification of ICD-10-PCS and ICD-10-CPT Procedural Code assignments
  • Verification of ICD-10-CM, ICD-10 CPT, Modifier, and Surgeon/Assistant Surgeon code assignments
  • Prioritization of Financial Impacts based on Coding Quality
  • Medical Coding and Provider Documentation Educational Opportunities
  • Verification of coding accuracy for medical necessity

Do you need a credentialed coding and auditing consultant on your side? Reach out to our experts and schedule a brief consultation call to discuss your organization’s needs.

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