Accurate coding a priority in healthcare revenue cycle
NEWTON, Mass.--(BUSINESS WIRE)-- Hayes Management Consulting announced that its MDaudit™ software user group meeting, April 13 in Orlando, FL, will focus on how accurate coding can support healthcare revenue cycle improvement. MDaudit Hospital and its counterpart for physician practices, MDaudit Professional, are used by healthcare organizations to mitigate risk, increase audit production, and increase accurate coding through root cause analysis. The services of more than 60,000 providers are currently reviewed by MDaudit. More than half of the “honor roll” organizations in US News and World Report’s “Top Hospitals” list are MDaudit clients.
Many institutions’ compliance departments are joining forces with revenue cycle under a new banner called “revenue assurance.” With resource constraints in both departments, there is an opportunity for finance and compliance to collaborate to help their organization obtain the correct reimbursement for services rendered.
In the article, “The Changing Face of Healthcare Coding,” recently published in HFMA’s Mass Media’s March issue, two MDaudit clients report on their innovative strategies. Capital Health in Trenton, NJ, reports that its finance and compliance departments have common ground – to get paid without errors. According to Stephen Miller, JD, Capital’s Chief Compliance and Privacy Officer, Capital’s compliance program “helps provide the Finance Department with a valuable product: ‘revenue assurance.’ By improving controls and reducing the opportunity for violation of payment rules, the program supports the finance function, which requires some level of assurance that it won't have to return payments received. Compliance supports finance with quality audits that improve the percentage of retained revenue.”
An exorbitant amount of time is spent “working down claims” in healthcare. Yet, this does not resolve the root cause of the problem. MDaudit enables root cause analysis to determine the cause of errors so that organizations can take action.
Physician/clinician education is one way to battle the incorrect claim. MDaudit client Kaiser Permanente Denver takes it a step further. James Taylor, MD, Medical Director of Revenue Cycle, has seen success with bringing the coders from the end of the revenue cycle to the beginning. According to Taylor, “Using coders in an upstream auditing and educational role was crucial to the success of attaining 95% accuracy in coding and claims accuracy in Kaiser Permanente Colorado.”
At the MDaudit user group meeting, clients can share their innovations and best practices. “We are excited to facilitate healthcare innovators through our MDaudit user group,” says Pete Butler, President of Hayes.
Learn more about MDaudit
MDaudit Hospital enables a proactive approach to risk mitigation in a time of dramatically increased government oversight (i.e., RAC, OIG, etc.). It enables in-house compliance staff to quickly and easily monitor risk and discover lost revenue opportunities. MDaudit Hospital allows you to use pre-loaded audit criteria or create new audit profiles based on regulatory targets, prioritize risk management programs on case volumes, defend claims with detailed documentation of findings and focus quality initiatives and education in areas that need improvement.
MDaudit Professional helps provider practices improve audit productivity, increase audit quality and enhance provider education. It automates the administrative duties of compliance auditing using strategic, risk-based audit methodology. MDaudit Professional allows healthcare organizations to identify, report and monitor risk areas more quickly. Increased productivity means that staff members' time can be allocated to physician education and other activities that provide direct value.
About Hayes Management Consulting
In addition to providing software solutions such as MDaudit, Hayes works with healthcare organizations to increase net revenue and improve patient experience. Hayes consultants are subject-matter experts in healthcare IT strategy, revenue cycle improvement, healthcare systems such as Epic, Allscripts and GE Healthcare, ICD-10 migration, ARRA/Meaningful Use and more.
Hayes has been ranked Top Professional Services Firm by KLAS for the past four years (2007 – 2010), and has received multiple Best in KLAS awards. We are also listed on the Healthcare Informatics Top 100 List and the Inc. 5000. To learn more about Hayes, visit www.HayesManagement.com or call us at 617-559-0404.
KEYWORDS: United States North America Massachusetts
INDUSTRY KEYWORDS: Technology Software Practice Management Health Hospitals