- Facilities
- Acute Care
- Inpatient/Outpatient Revenue Cycle Maintenance Program
- Outpatient (OPPS) Revenue Cycle Maintenance Program
- Emergency Department (ED) Program
- Comprehensive Chargemaster Update
- Chargemaster Update - Desk Review
- Pass-through Code Identification Review
- Chargemaster Update - Single Department or New Service
- Chargemaster Follow-Up Review
- Chargemaster Training Program
- Acquisition Feasibility Study
- Compliance Program Development and Audit Services
- Independent Review Organization
- RAC Pre-Audit & Appeals Services
- Teaching Facilities
- Inpatient/Outpatient (IPPS/OPPS) Full Service Program
- Outpatient (OPPS) Full Service Program
- Emergency Department (ED) Program
- Comprehensive Chargemaster Update
- Chargemaster Update – Desk Review
- Pass-through Code Identification Review
- Chargemaster Update – Single Department or New Service
- Chargemaster Follow-Up Review
- Chargemaster Training Program
- Acquisition Feasibility Study – Chargemaster
- Compliance Program Development and Audit Services
- Independent Review Organization
- RAC Pre-Audit & Appeals Services
- Critical Access Hospitals
- Inpatient/Outpatient (IPPS/OPPS) Full Service Program
- Outpatient (OPPS) Full Service Program
- Emergency Department (ED) Program
- Comprehensive Chargemaster Update
- Chargemaster Update – Desk Review
- Pass-through Code Identification Review
- Chargemaster Update – Single Department or New Service
- Chargemaster Follow-Up Review
- Chargemaster Training Program
- Acquisition Feasibility Study – Chargemaster
- Compliance Program Development and Audit Services
- Independent Review Organization
- RAC Pre-Audit & Appeals Services
- Long Term Acute Care Facilities
- Inpatient Full Service Program
- Comprehensive Chargemaster Update
- Chargemaster Update – Desk Review
- Pass-through Code Identification Review
- Chargemaster Update – Single Department or New Service
- Chargemaster Follow-Up Review
- Chargemaster Training Program
- Acquisition Feasibility Study – Chargemaster
- Compliance Program Development and Audit Services
- Independent Review Organization
- RAC Pre-Audit & Appeals Services
- Inpatient Rehabilitation Facilities (IRF)
- Inpatient Rehabilitation (IRF) Full Service Program
- Comprehensive Chargemaster Update
- Chargemaster Update – Desk Review
- Pass-through Code Identification Review
- Chargemaster Update – Single Department or New Service
- Chargemaster Follow-Up Review
- Chargemaster Training Program
- Acquisition Feasibility Study – Chargemaster
- Compliance Program Development and Audit Services
- Independent Review Organization
- RAC Pre-Audit & Appeals Services
- Skilled Nursing Facilities
- Acute Care
- ASC
- EMS
- Physicians
- Home Health
- Hospice
- Coding
Ambulatory Surgery Center Review Program
The program includes analysis of Client's ASC services impacted by CMS OPPS: review of entire surgery center CDM line items for accuracy of the CPT/HCPCS, UB revenue code, and modifier assignment for compliance with federal and fiscal intermediary rules and regulations, price comparison vs. allowable reimbursement levels, and review descriptions for meeting Client's internal standards. Additionally, our consultant specialists perform reviews of the medical records and billing documents to ensure coding (ICD-9-CM, CPT, HCPCS) compliance with current guidelines and optimal reimbursement from all payors.
The scope of the engagement may include monthly, bi-monthly, or quarterly on-site services with our consultant specialist who will provide technical expertise to include:
- Comprehensive outpatient chargemaster departmental reviews
- Charge screens/order entry reviews corresponding to CDM maintenance
- Reviews and updates for department charging tools
- Bill audits for ASC services
- Medical record reviews for outpatient services
- Continuing education for surgery center staff
- Implementation and quantification of recommendations
Added Feature:
- Coding and Billing Helpline provided at no additional cost during the term of the contract. Client's staff may take advantage of this helpful service to communicate directly with their on-site consultant specialist when billing and coding questions arise from daily operations.
