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RESOURCES AND TOOLS
Management, Medical Record, and Health
Information Professional Services (Providers, Clinicians, Coders,
Billing Staff, Practice Managers)
·
Benchmarking and Data
Expertise
o
Administrative Data –
MEDPAR,
o
Assessment Data –
UHDDS, MDS, FIM, OASIS, etc.
o
Cost Data – Annual
Medicare Cost Reports (2552, 2540, etc.)
o
Census/Geographic
Data – Local, Regional, and National Data/Boundaries
o
Payment Rate Data –
Medicare & Other Payor Rates by Setting/Group/Code
·
Information,
Management, and Decision Support
o
Efficiency/Staffing/Costing Analysis – Within and Across Settings/Payors
o
Disparities Analysis
– Demographic, Geographic, Organization, & Other Predictors
o
Strategic
Restructuring Across Settings
o
Volume/Market/Budget
Analysis and Projections
·
ICD-9-CM Coding
Expertise
o
RAC Audit Appeals and
Support
o
Provider (NP, PA, MD)
education and training
o
Medicare, Medicaid, &
Commercial payer ICD-9-CM coding compliance audits
o
Involvement with
ICD-9-CM Coordination and Committee meetings
o
Revision of ICD-9- CM
codes based on NWI proposals
·
CPT Coding Expertise
o
RAC Audit Appeals and
Support
o
ED Evaluation
&Management (E&M) Reviews and Training
o
Interactive staff
training for ‘Application of the Rules’
o
Chart-to-bill audits
for OPPS, Medicaid, Commercial Payers
o
Data benchmarking
(facility specific)
o
Medicaid and Medicare
provider audits
o
Onsite Coding
Training Product (AAPC)
o
Coding education,
monitoring and documentation training |
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