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Enhanced Quality and Compliant Coding Positively Impacting Reimbursements and Denials with IKS Coding Audit

Pulished on: April 7, 2025

Denials Management, Denials Prevention & Management, Healthcare Compliance, Healthcare Reimbursement, Medical Coding, Medical Coding & Compliance, Revenue Cycle Management

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.