Coding
Our coding and clinical documentation improvement (CDI) methodology focuses on proactive risk mitigation and uncompromising documentation integrity. By integrating targeted Clinical Documentation Improvement (CDI) on high-risk DRGs, systematic internal quality audits, and advanced automated claim scrubbing, we ensure precision and compliance before claims are ever finalized. This comprehensive strategy unites technological automation with continuous clinical education to capture the true complexity of patient care while preventing preventable administrative errors.
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How We Support Our Clients
Our approach relies on a comprehensive, multi-step process integrated directly into hospital workflows.
We prioritize analysis on DRGs with significant downgrade exposure and high-risk outpatient procedures prone to audit review, developing specific queries to clarify ambiguous clinical indicators and delivering targeted education to physicians on documentation requirements.
We assist in the design of systematic, regular internal coding audits across all hospital departments to identify coding error patterns and trends prior to claim finalization, performing deep root cause analyses and developing monitored corrective action plans.
Utilizing advanced technology within a pre-submission workflow, we automatically detect and resolve Correct Coding Initiative (CCI) violations and Medically Unlikely Edits (MUE) to prevent bundling denials, coupled with monthly data-driven education sessions for coders and physicians.
Coding
Clinical Documentation Improvement focused on high-risk DRGs, quality audits to catch coding trends, and claim scrubber integration for CCI and MUE compliance.
We prioritize Clinical Documentation Improvement (CDI) focus on DRGs with significant downgrade exposure and high-risk outpatient procedures prone to audit review.
Perform regular internal reviews to identify trends in incorrect coding before claims are finalized.
Using advanced technology, we catch CCI violations and MUE before claim submission, coupled with monthly physician and coder education.
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