An Essential Transition from In-House to Outsourced Coding Services

A multi-specialty pediatric facility sees improvements in radiology and emergency department revenue after transition to HAP’s proprietary coding platform.

In today’s complex healthcare economy, it can be challenging to collect every dollar your practice has earned. Documentation issues and gaps in physician education can easily get in the way of full reimbursement.  A Tampa, Florida area multi-specialty pediatric group with over 200 physicians knew these problems all too well before they made the decision to partner with HAP.

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Improving documentation in a changing regulatory environment

The network was faced with a radiology coding backlog. Documentation issues persisted as they struggled to educate physicians through the transition from ICD-9 to ICD-10. The turnaround time for charge entry was creating timely file payment denials.

HAP stepped in to handle the radiology coding with immediate collaboration between HAP’s team and the facility’s IT department.  The transition from their internal billing system to HAP’s proprietary coding platform, CODIA® commenced.  With the use of CODIA, a more efficient coding process was launched through a workflow management system that utilizes 100% accession auditing, ensuring that each patient encounter is coded correctly with accurate CPT assignments. The coding backlog was eliminated and the network quickly saw positive results following the transition.

The internal billing system was not the only improvement implemented at the facility. HAP introduced them to the Physician eQuery Portal, a tool that quickly communicates any documentation issues directly to the reading physician so he or she can make the necessary modifications. Use of the Portal has led to a decrease in documentation issues through real-time daily amendment requirements communicated directly to the physicians and their department administrators.

Positive results in radiology coding provide opportunities for an expanded relationship

Education from HAP’s expert, certified coders has increased coding accuracy and reduced charge lag. Improvements in turnaround time have led to more consistent cash flow.  Average date-of-service-to-bill and average date-of-service-to-paid-claim numbers have improved.

The increase in radiology reimbursement paired with the positive reception to the eQuery Portal and physician education in the radiology department led to the addition of emergency  department (ED) coding to HAP’s scope of service. Expert, certified coders with specific training and credentials within ED coding, including evaluation and management, critical care and patient observation code-sets, provide critical knowledge of new coding requirements within the entire realm of emergency medicine.

Two companies reaching for a singular goal of coding accuracy and efficiency

HAP acted an extension of the facility’s physicians and management staff to overcome their coding challenges. We worked with their team to spearhead a smooth transition from in-house to outsourced coding that eliminated backlog, decreased documentation issues and ultimately increased revenue collected. It’s what a true business partner does, and what you can always expect of HAP. That is why client referrals represent our #1 source of new business.

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