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Right coding provides optimal reimbursement. PivotHealth’s coding team distinguishes itself with a comprehensive program focused on 1) delivering best of class coding and compliance audits and corrective actions, and 2) providing highly effective training programs that raise the level of expertise among a medical group’s staff.
Some of the components of our program include:
Quarterly Coding Audits
- Ensure adherence to the Documentation Guidelines.
- Provide physician education (either group or individual) on specific areas of opportunity.
- Provide trend analyses to help the individual & group see the results and impact of their work.
• Audit • Measure • Educate • Re-audit • Quantify
Compliance Oversight which includes.
- Reviewing production reports.
- Reviewing and modifying compliance plans to ensure accurate coding (both ICD-9 and HCPCS) within regulatory requirements.
Staff Training and Education.
Evaluation and Management benchmark comparisons.
Standard Methodology (adapted for unique situations)
- Conduct an onsite, baseline audit for each provider to establish compliance ratios by provider, by group/location and for the overall practice.
- Conduct an analysis of coding patterns for the group and each provider within the group compared to normative databases.
- Assist medical group in designing and implementing an overall measurement and improvement program.
- Establish a Compliance Oversight Committee.
- Repeat audits quarterly.
- Using both on-site and remote interventions and training, identify and deliver individualized training programs for specific providers and the group as a whole.
- Develop customized standard coding/compliance support tools and mechanisms, including: quarterly department meetings by specialty, coding newsletters; re-audits for providers not meeting minimum compliance standards.
- Track and demonstrate improvement over time via quarterly benchmark reporting.
Click here to request more information about Medical Coding and Compliance.
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