HIApro assists healthcare providers by performing coding, billing, documentation compliance reviews and education. Our comprehensive service will discover trends that may adversely affect quality scores, identify high risk areas prone to payor audits, help reduce claims denials and ensure appropriate reimbursement.
The number of physicians employed by health systems continues to rise. This growth will bring increased financial and compliance related risks. As the industry moves towards a value-based payment model, quality metrics and costs will dictate reimbursement. Additionally, government and commercial payors are poised to scrutinize claims more aggressively. The need for qualified professional coders has never been greater.
HIApro Offerings
Why HIA’s profee service is different
- Annual Client Satisfaction 98%
- Average Client Relationships Over 5 Years 95%
- Average Client Relationships Over 10 Years 85%
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Client X: Let’s Talk Numbers
A higher CMI corresponds to increased consumption of resources and increased cost of patient care, resulting in increased reimbursement to the facility from government and private payers, like CMS. We know that documentation directly impacts coding.
Coding Tip: Endarterectomy During Coronary Artery Bypass
Lately we have seen several cases where the endarterectomy was assigned along with the coronary artery bypass (CABG) procedure when being performed on the same vessel to facilitate the CABG. A coronary artery endarterectomy is not always performed during a CABG procedure, so when it is performed it becomes confusing as to whether to code it separately or not.
Coding Tip: Update – Coding COVID-19 When the Test is Negative
Assign code Z20.828, “Contact with and (suspected) exposure to other viral communicable diseases” for all patients who are tested for COVID-19 and the results are negative, regardless of symptoms, no symptoms, exposure or not as we are in a pandemic.
New ICD-10-PCS Procedure Codes for COVID-19
The Centers for Medicare & Medicaid Services (CMS) announced new procedure codes for treatments of COVID-19 – effective as of August 1, 2020. Among the new codes are Section X New Technology codes for the introduction or infusion of therapeutics including Remdesivir, Sarilumab, Tocilizumab, transfusion of convalescent plasma, as well as introduction of any other or new therapeutic substances for the treatment of COVID-19.
New Rule Helps Medicare ACOs During COVID-19 Pandemic
One common element in many value-based programs is risk adjustment using Hierarchical Condition Categories (HCCs) to create a Risk Adjustment Factor (RAF) score. This method ranks diagnoses into categories that represent conditions with similar cost patterns.
HIApro Reports
HIA delivers comprehensive electronic daily and month-end reporting to its clients. The content and format of these reports promote transparency and allow for easy invoice reconciliation.
HIApro Reports
HIA delivers comprehensive electronic daily and month-end reporting to its clients. The content and format of these reports promote transparency and allow for easy invoice reconciliation.
