How the Right Coding Team Can Restore Revenue Cycle Health

A healthy revenue cycle, like the human body, is dependent upon complex, interdependent systems working in harmony to keep the whole entity functioning properly.

And like human well-being, achieving optimized financial health doesn’t happen by accident. Today’s dynamic healthcare economy demands efficiency in all practice areas in order to achieve desired outcomes in patient care and provider compensation alike. Missing documentation, overlooked details, and processing errors all contribute to delays in reimbursement as well as potential compliance issues. Today’s practice leaders overcome these challenges by taking action to mitigate problems as far upstream as possible – and by choosing the right coding outsourcing partner.

Such was the case for a multi-specialty practice of 150+ physicians based at a community hospital when they outsourced professional coding duties to HAP. The goals: drive clinical documentation improvement, increase the number of services coded, ensure that no charge is left behind, and maximize overall process efficiencies and practice revenue.

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How we did it

CODIA® is HAP’s proprietary workflow management system – a tool developed and continually refined to automate and manage many of the tasks needed to complete the coding process faster and error-free. As the first major milestone in the upgrade of the workflows, HAP interfaced the practice records into CODIA and thus replaced the inefficient, labor-intensive process that was resulting in charge delays.

Beyond the technology, HAP’s team of coding experts invested time working with the hospital HIS staff to diagnose and cure a number of difficult workflow issues that were impeding revenue growth.

Documentation issues – chief among the core concerns at the start of the engagement – were tackled using HAP’s Physician eQuery Portal. This online accessible tool, embedded within CODIA, enabled HAP’s coding team to communicate with providers and educate them about missing or unclear documentation, unsigned reports, and other potential problems in order to expedite response and resolution. And with RVUs and compensation at-stake, the physicians quickly realized the value of the improved process. With coding delays further reduced, revenue cycle health was restored.

Results

Following the full transition to HAP’s outsourced coding services, the benefits realized by the practice were dramatic:

• A 60% improvement in average un-coded monthly charges

• A 61% appropriate increase in new patient E&M Levels 3, 4, and 5

• Over $1 million in additional charges posted

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Looking to change medical coding vendors? Contact HAP to see what we can do for your practice.