RCM Services
Improve Mid-Revenue Cycle Process Efficiency, Reduce Denials, and Maximize Financial Outcomes.
We recognize the complexity to maintaining the quality of Mid revenue cycle processes. Especially for organizations with limited resources. Payers are denying more claims than ever, putting additional pressure on providers and consuming a lot of their time and effort for claims management. Our extensive knowledge and advanced technology help you navigate the intricacies of Medical Billing, Coding, and Clinical Documentation. At High Care, we provide efficient mid-revenue cycle services, that improve reimbursement, reduce denials, and enhance compliance. Our team of professionals is always staying current with the ever-changing healthcare regulations in order to provide high-quality services and maximize revenue.
High Care offers reliable and accurate medical coding services to healthcare organizations. Our certified coding experts stay updated with coding guidelines and industry regulations to ensure compliance. Our training methodology for coders includes comprehensive training programs and regular assessments. Our coding process involves validating patient charts, accurate coding, and thorough quality audits.
Our services include CPT, ICD, and HCPCS coding, coding audits, provider education, and denial management coding. Benefits of our services include enhanced compliance, reduced denials and improved reimbursements.
Neglecting the importance of quality documentation will lead to Revenue leakage. Precise and complete clinical documentation is fundamental to quality care and faster reimbursement. However, improving clinical documentation can be challenging, especially for providers with limited resources. Boost the performance of your current CDI program through flexible and tailored CDI services guided by our highly skilled CDI Specialists.
Our experienced team has expertise in reviewing medical documentation and report the physicians of any issues. At High Care, we help providers capture patient data accurately, increase collections, enhance quality scores, and improve clinical outcomes with our CDI services.
Clinical Documentation Improvement Services:
- Perform a complete review of all relevant medical records to ensure the documentation is adhere to coding guidelines and requirements of government and commercial payers.
- Identify and perform root cause analysis of documentation issues that impact coding, denials and quality scores.
- Educate the treating physicians, nurses and CDI teams on missed documentation and coding accuracy.
- Develop systematic relationship between coding, physician and CDI teams.
Benefits of our services:
- Maximize reimbursements.
- Streamline medical coding process through accurate documentation.
- Increase the patient’s quality of care.
- Assure compliance of clinical documentation.
Constantly maintaining coding accuracy and staying up-to-date with continuously changing government regulations may be a daunting task for coding and physician teams. High Care’s coding audit services can help improve your coding accuracy and clinical documentation that is in compliance with all CMS, OIG, and other regulatory entities’ requirements. Our highly-trained and experienced coding auditors prospectively and retrospectively conduct an audit on a particular problem area (provider-specific, specialty or facility-specific and/or code set-based) or a complete audit, depending on your needs and goals.
At High Care, we provide fully customizable coding audit services and education for providers to help reduce claim denials and improve ROI.
Coding Audit Services:
- Determine the scope of the audit based on provider requirements.
- A team of certified coding auditors performs an in-depth audit of coding and clinical documentation, including CDI query review.
- Providers are given a final audit report that outlines audit findings, including missed coding and query opportunities, along with references such as CPT Assistant, ICD-10 Guidelines, Coding Clinic.
- Educational sessions are given to physicians, coders, and CDI teams to understand the areas of improvement and address the root cause of errors to prevent them in the future.
Benefits of Services:
- Increase efficiency and accuracy of medical coding.
- Reduce claim denials.
- Improve bottom line through accurate reimbursements.
- Ensure coding and documentation compliance.
An effective Charge Entry process is critical to accurate reimbursements for the services rendered by physicians. Any missing or incorrect charges directly lead to revenue loss and increased denials. Maintaining accuracy in charge entry and keeping pace with frequent updates of charges and codes is a necessary yet complex process. High Care can help. Our seasoned charge entry experts with expertise in multiple specialties, provide you with highly accurate and customizable charge entry services. And also perform charge audits to ensure clean claims are submitted.
Implement the latest software technology to streamline the process. Our charge entry specialists collaborate with the coding team to improve the precision and compliance of Charge Entry services.
Charge Entry Services:
- Receive documents as superbills, charge tickets, and clinical documents through FTP, EHR or document management system.
- Precisely capture the patient demographic information, date of service, billing and referring provider, POS, date and time of admission, CPT/ICD codes, number of units, and modifiers.
- Charges are captured and compared against the pre-determined fee schedule according to a specific set of patient account rules along with supporting documents.
- Entered charges and codes are audited by our Quality Assurance (QA) team to identify and correct any billing and coding errors.
Clean claims are submitted to clearing house.
Benefits of our services:
- Ensure accurate reimbursements.
- Reduce denials and rejections through clean claim submission.
- Prevent revenue leakage through our precise charge entry process.
- Fast turnaround time.
- Improve compliance.
