Health Care Reimbursement and Compliance Specialists provides comprehensive reviews designed to optimize coding for procedures performed, service rendered and resources expended for U.S. healthcare facilities.
Inpatient and outpatient areas are reviewed for appropriateness of coding and charging, including business office activities, systems function and charging methodologies.
A review of U-B92's, itemized bills and remittance advices is performed on a sample provided by the client.
An analysis of the complete hospital Charge Description Master (CDM) is performed off-site, reviewing description, HCPCS/CPT coding, revenue coding, and charges.
On-site, key managers are interviewed to confirm findings and to identify other opportunities for improvement. The review often identifies procedures being performed but charged as part of other procedures or not charged at all. Risk, identified as inadvertently charging for procedures not performed or inappropriately unbundled is identified, as well. Any uncovered compliance related items are discretely reported to executive administration or to corporate attorney, as appropriate.
A summation conference is held with executive administration at the conclusion of the on-site portion of our work. This is followed by a formal written report, outlining opportunities for improvement, in detail.
The review may include optional, on-site submission/explanation of findings, a 90-110 day follow-up review of implementation, and/or contract for retainer; to assure ongoing review and update of CDM, with revisions as needed.
HCRCS utilizes only highly regarded consultants, skilled in such reviews, with considerable experience, and with impeccable references.
It's your call. Why not contact HCRCS for more information. We will send a confidential proposal for your consideration and are prepared to meet with you at your convenience. Contact us today!
335 Derbyshire Lane
Riva, MD 21140-1510
(410) 956-7271
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