Medical Multi-specialty practice located in New Jersey with over 50 providers
Project Description: Provide annual review of documentation and coding acuracy for a sample of each providers records, with analysis for acuracy and supportability. Based on review, we provide both group and individual training to providers to point out areas of needed improvement.
Results / Value Proposition: Based on these annual reviews, client has been able to achieve a high level of revenue integrity, minimizing underpayment and the risk of payor audit issues.
Skilled Nursing Facility in New York City
Project Description: Assisted client negotiation of payment for denials of service claims for adult day care program from as far back as one year. Also, guided staff in correcting processes that led to denials in the first place.
Results/Value Proposition: Client was able to receive $95,000 of reimbursement that was previously espected to be written off.
Ambulatory Surgery Center in New York City
Project Description: Conducted review of accuracy of coding, supportive documentation, and revenue cycle process, resulting in identification of underpayment issues
Results / Value Proposition: Client was able to receive over $ 1 million of reimbursement that was not previously being billed for properly.