Coding Case Study 1

Coding Case Study 1 Problem Statement OK based hospital identified their CMI value was trending upto 0.9, for the last quarter. From their basic research, they realized a huge revenue was incurred as an impact on this CMI value. Project Objective To increase the case mix index value of IP DRG from 0.9 to 1.2 […]
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Coding Case Study 2

Coding Case Study 2 Problem Statement Increased denial rate due to inappropriate coding by in-house team Project Objective To reduce the denials and increase the clean claim percentage for better reimbursement Root Cause Analysis After a detailed study, we identified the below listed challenges which caused the denials Improper usage of Modifiers, Diagnosis pointers Payor […]
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DNFB reduction for Hospital Coding

Decreased DNFB days for an acute care Hospital Client: An Alabama based private, not-for-profit, acute care facility which serves the community for more than 70 years. It serves more than 100,000 patients annually. Challenge The hospital faced an increased DNFB due to contract termination with their existing vendor as well as inefficient workflow which resulted […]
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charge capture

Charge Capture Audits For Physician Coding

Case Study: Accurate charge capture and customized coding edits in charge capture application has reduced denial rate by 12% Client: A large physician group who has an expansive physician network across the united states with high-quality hospitalists and surgicalists that are passionate about helping rural hospitals meet the needs of the communities they serve. Challenge […]
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