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Coding Audits & Education

Inpatient and outpatient coding accuracy of both procedure and diagnosis codes is crucial to submission of a clean claim and appropriate reimbursement.  Due to the fact that codes change on a quarterly and annual basis, it is important to remain current and knowledgeable on an on-going basis. We not only offer detailed coding audits of inpatient and outpatient records, among other financial improvement services, but also education on code updates and feedback to the coding team post-audit for continuous improvement.

Benefits

  • Hospitals receive specific feedback on each audited record.
  • The process provides suggested changes and financial impact of any DRG or ambulatory payment classification (APC) changes.
  • Staff receive education on relevant topics based on audit results.
  • Education on CPT/HCPCS code updates is provided as each quarterly and annual change becomes effective.

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The Far-reaching Impact of Your Hospital’s Cost Report

Ever-expanding in complexity, cost reports influence current and future reimbursement levels for your hospital. Think of a cost report as an annual report with numbers instead of words. Far-reaching in scope, mistakes can result in lost revenue that may profoundly affect your hospital’s sustainability and ability to effectively serve patients.

The Center for Medicare and Medicaid Services (CMS) requires Medicare certified hospitals and other Medicare reimbursable provider facilities to file cost reports annually that identify the costs and charges related to facility Medicare reimbursable activities. Acting as annual reconciliations, these...

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