Enhanced Quality and Compliant Coding Positively Impacting Reimbursements and Denials with IKS Coding Audit
Client Profile:
Large academic medical center in the Southeast with over 1800 physicians providing leading-edge patient care offering more than one hundred medical specialties, including a leading eye hospital, NCI designated cancer center, cardiac surgery program and over 40 outpatient sites.
Challenge:
Client seeking coding audit partner to support coding compliance program and ensure compliant coding and reimbursements. Required ongoing coder education to maintain compliance with coding guidelines and regulations.
Approach:
- Implemented IKS Coding Audit Solutions to identify focused areas for audit and established baseline accuracy for all coding patient types and specialties
- Established governance process and frequency from weekly governance to biweekly governance to ensure success of partnership
- Established pre-bill audit process and turnaround time (TAT) to enhance quality and accuracy of coding prior to claim submission
- Created client specific reporting based on defined business outcome metrics
- Tracking and trending outcomes by coders to ensure quality improvement
- Delivered monthly coder education based on audit findings and trends and provided education to coding leadership (management and supervisors)
Results:
- Governance process implemented to mitigate potential risk in a timely manner resulting in customers policy enhancements
- Customized reporting to support coder remediation process
To learn more about IKS Health Medical Coding Audits, contact us today at info@ikshealth.com.
