ICD-10 coding can have a significant impact on hospitals and other healthcare organizations’ bottomline. Through our ICD-10 services, we review where you may be leaving revenue on the table.
We draw from proprietary analytics and more than 30 years of coding expertise to conduct in-depth review of your ICD-10 coding and determine where processes could be improved or streamlined. Our I-10 Check solution differs from other coding evaluations in a number of ways.
Identifying Key Risks
Most coding audits rely on random samples or 100 percent reviews of a specific diagnostic-related groups (DRGs) or a clinical family of DRGs. With our proprietary data analytics, we are able to sift through thousands of cases to focus on those accounts that have a statistically likely risk for under- or over-coding. These cases could represent compliance issues or revenue shortfalls.
Our approach enables us to perform a pinpoint review of your hospital’s ICD-10 performance. CBIZ’s certified ICD-10 experts will save you valuable time and resources by focusing on what statistically may be at risk, broken or unable to be fixed.
The services we provide are designed to complement your hospital’s existing CDI program, ICD-10 task force or internal audit initiatives; it is not designed to replace them. Our product’s statistically driven identification of coding, compliance and revenue issues allows you to clearly evaluate progress on these initiatives. By using CBIZ, you will be able to monitor improvement in your ICD-10 coding and correct the inevitable coding erosion that follows such large-scale changes. The product identifies potential issues before they escalate into more substantial problems.
Finally, as with all of our data-driven improvement products, we then work with you to make sure any issues get fixed and stay fixed through continual monitoring and education.
By using CBIZ, you will be able to answer in a quantitative manner – that is both measurable and defendable – the three critical questions senior management and your auditors will ask about your hospital’s 1CD-10 coding:
How accurate is our coding? CBIZ examines your data to identify specific records that could be at risk for over- or under-coding. Then, our experts review these charts to ensure optimal coding accuracy for the at-risk records. We provide detailed reporting of its findings and works with your health information management staff to correct issues.
Is our reimbursement what it should be? We not only identifies potential reimbursement issues, but also allow you to rebill those cases within the permissible payment windows, ensuring that your reimbursement is complete and accurate.
How is our coding compliance? Our reviews your coding data eliminate potential compliance issues. Our process provides for the review of specific cases at risk and allows for the training and education of your staff on corrections going forward. In addition, the data analytics employed by CBIZ allow you to monitor improvement over time so that once something is fixed it stays fixed.