Posts Tagged ‘coding audits’
How to Empower a Medical Coding Team During an Audit
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.
Read MoreCoding Compliance Audit Statistics: What to Do With Them?
Year by year, organizations rely more and more on their data analytics. In this article you will be provided with: An overview of key statistics to include in your coding compliance audits, a Questionnaire to determine if you need a coding compliance audit program…
Read MoreAchieve 99% Coding Accuracy with Mentoring, Auditing, & Education
How do you shape the future of an accurate Inpatient, Outpatient, or Profee coder? With several best practices that have been thoroughly tested by a team of real-world coding and auditing experts who have 20+ years’ experience in HIM.
Read MoreCoding Audit Data Analysis is Key to Pinpointing Revenue-Killers
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.
Read MoreCMS PEPPER Report to Include Total Knee Arthroplasty (TKA)
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a quarterly electronic data report that contains a hospital’s claims data statistics for Medicare Severity Diagnosis-Related Groups (MS-DRGs) (PEPPER, 2020). CMS has approved the addition of a new target area to the quarterly PEPPER report related to inpatient total knee arthroplasty (TKA) (PEPPER, 2020).
Read MoreMaking the Data Work for You: How to Turn Medical Coding Audits into Actionable Insights
Coding audit data can be extremely beneficial to the success of a healthcare organization – however, oftentimes, the vast amounts of data being collected can suffocate the organization, especially those that don’t know how to cultivate value and act on the insights received from the audit process. Most medical coding compliance audit programs will objectively evaluate multiple data sets and generate reports on the findings, but, the data is not being used to its fullest potential if the reports are not properly cleaned, analyzed, and examined to develop strategic next steps toward the company’s quality improvement. “Data and quality improvement go hand-in-hand”, says Crumbley.
Read MoreStrategies to Grow ProFee Coder’s Skills, Quality, & Accuracy
Growing a ProFee coding department’s accuracy and quality can be a daunting task – especially if the healthcare organization doesn’t know where to start. Our team of accomplished HIM and medical coding experts has 20+ years’ experience in the industry and is ready to develop a ProFee Coding Quality Improvement Plan specifically tailored to each organization’s goals. Facilities or healthcare organizations that need help developing their ProFee coders should contact us today.
Read MoreCase Study: Coding Quality Improvement Plan for Healthcare Facility Acquisition Process of a Large Physician Group
Healthcare facilities and independent practices face unique challenges when merging or being acquired. As an HIM and Coding consulting company, YES has encountered several opportunities to implement auditing, coding, and education improvement plans in similar scenarios. This case study provides a thorough analysis on the unique challenges a medical facility faces when merging with independent practices, as well as solutions for a successful facility acquisition process. Challenges impact overall medical coding quality, turnover rate, productivity and the bottom line. The analysis covers the solutions implemented, and an overview of the impact these presented to a facility, practiced over a 33-month period.
Read MoreMedicare Advantage Insurers Use Reviews to Get Higher Payments
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.
Read MoreCase Study: Coding Quality Improvement Plan for Healthcare Facility Acquisition of a Large Physician Group
This case study summary provides an analysis on the unique challenges a medical facility faces when merging with independent practices (I.E. the impact on overall medical coding quality, turnover rate, and productivity), and the solutions we have crafted to be implemented for maximum results.
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