MID REVENUE CYCLE SUPPORT
Medical Coding Support and Coding Audit Services
We provide revenue integrity and compliance audits, medical coding support, and clinical documentation audit services. Trusted by hospitals, ambulatory surgery centers, and physician groups, HIA offers both PRN and total outsource support to enhance healthcare accuracy and efficiency.
CODING EDUCATION PLATFORM
HIAlearn includes over 200 facility and professional fee courses
accepted by AHIMA for CEUs, with a selection also accepted by AAPC.
MEDICAL CODING AUDIT PLATFORM
Atom Audit is a cloud-based application that
allows auditors to perform comprehensive
medical coding reviews.
Coding Audit Platform
Atom Audit
Our coding audit tool is a cloud-based application that allows
auditors to perform comprehensive medical coding reviews.
Cloud Based
No install required. Access from anywhere, anytime.
Increased Auditor Efficiency
Coder Response Workflow
Coder access included for full rebuttal response process.
Audit Insights
Results from any audit can be viewed online or downloaded via our Reports dashboard.AI Validation Audit
At HIA, we prioritize developing AI solutions that are both effective and reliable for your coding needs. We are dedicated to helping you achieve:
- Reduced Errors
- Assured Compliance
- Accurate Billing
- Optimized Revenue
- Transparent Processes
- Ongoing Learning
- Integrity in Documentation
Due Diligence Audit
Trust us to safeguard your transactions with expert auditing tailored to meet the rigorous demands of healthcare M&A. Let us help you:
- Identify Compliance Risks
- Evaluate Financial Health
- Assess Coding and Billing Frequency
- Ensure Legitimate Compensation
- Mitigate Risk
- Enhance Integration Processes
Total Outsource Coding Support
Today's healthcare environment is already challenging enough. Let us help you achieve:
- Guaranteed staffing
- Appropriate and timely reimbursement
- Representative quality measures
- Improved CMI
- Reduction in payer denials
- Mitigation of compliance risks
Single Path Coding
Whether you are considering, or in the process, or have implemented Single Path Coding, we're here to help. Our clients have seen:
- Increases in overall productivity and accuracy
- Decreases in claims denials
- Significant reduction in operational costs
Interim Auditing
We provide experienced coding consultants when you need them most:
- One-on-one coder development/improvement
- Address surging payer denial/appeal volumes
- Assess coding's role in CMI fluctuations
- Investigate skewed quality metrics
- Supplement internal staff for focused auditing (DRGs/Dx, mortality, PSIs, monthly coder reviews, etc.)
- Manage and resolve billing edits
Rev Cycle Management
HIA’s Revenue Cycle Management service can assist your organization in one or a combination of the following:
- CMI impact - CC/MCC capture
- Billing edit resolution
- Focused DRG audits
- CDI audits
- Claims denial audits/Appeal support
Denial Management
HIA’s Denial Management service will assist your organization in one or a combination of the following:
-
Review applicable denied and/or rejected claims
-
Determine if an appeal is warranted
-
Facilitate appeal process including authoring of appeal letter, tracking and adjudication
-
Analysis of denials and operations assessment to determine root causes.
-
Corrective action recommendations, education to applicable stakeholders
Case Mix Index
Are your coders capturing all CC/MCCs? If not, it could be negatively affecting your CMI and quality measures. In addition to reviewing CC/MCC code selections for both medical and surgical MS-DRGs, we:
- Investigate cases where there is a single reporting of a CC or MCC in a given time period as this can indicate a coding error or a provider documentation opportunity.
- Review a sudden spike or unusually high volume of MS-DRGs with CC/MCCs as this can be an indicator or an increased denial risk and can impact mortality index reporting.
- Evaluate outliers in the average length of stay where inconsistencies can identify coding and documentation opportunities.
Our Education
Our Reporting
Our Support
HIAlearn.com - Over 200 Courses
Topics are derived from common HIA audit findings and range from the day’s most challenging procedures to wider reaching concepts such as Principal Diagnosis Coding.
Join more than 1,600 HIAlearn.com users today.
- One hour Courses
- Ten question quiz
- Submit for CEUs
HIA's secure client portal
Nucleus, HIA's secure client portal, allows you to run customizable reports while seamlessly managing your current monthly costs and upcoming projects. As a cloud-based platform, all of the documents are updated and logged in real-time. Nucleus makes it easy to share documents and reports with all assigned users and schedule services for up to a year in advance. Even better? We have specific reports for each department.
- Are you in Coding Leadership role? See a summary of findings, including overall accuracy and potential CMI impact.
- Are you in a Compliance role? Run DRG Rebill report to show you a detailed list of all accounts, including their potential financial impact.
- Are you a member of the C-suite? Get a global view of the project with easy-to-read charts and summaries.
More than just one coder
- Our Education Team has 70+ years of combined education experience.
- Our Corporate Team has 20+ year tenure.
- HIA has been in business for 30 years.
Hospitals
Accurate coding of inpatient & outpatient services is a crucial element in a healthy reimbursement and compliance strategy. Partner with HIA to replace underperforming coding vendors or to provide comprehensive medical coding reviews.
Physician Groups
Physicians and mid-level providers, both employed and independent, continue to face financial and compliance related challenges. Partner with HIApro for all of your professional fee consulting needs.
Ambulatory Surgery Centers
Rarely does an ASC have the luxury of a dedicated coding manager, much less an educator and internal auditor. HIA’s service is aimed at providing a reliable resource to address all three important functions and more.
Behavioral Health
Behavioral health related services are on the rise in the United States with around 20 million Americans experiencing a mental health illness. HIA can address your coding and reimbursement needs for both the facility and the provider.
Critical Access Hospitals
HIA has developed a package exclusively for CAHs that addresses common coding challenges – all for one affordable fee.
Urgent Care
HIA partners with Urgent Care facilities to ensure their coders and providers are following all of the updated coding guidelines.
Rehabilitation Centers
HIA partners with Rehabilitation Centers to ensure their procedure and diagnosis coding is complete and accurate.
Rural Health Clinics
HIA employs coders and consultants who are specialized in coding for Rural Health Clinics and understand the unique RHC guidelines.
Pediatric Hospitals
HIAs credentialed coders are up-to-date on all ICD-10 and CPT pediatric coding guidelines. With our expertise, children's hospitals can focus on what matters most: providing top-notch care to their young patients.
"Your audits were very helpful, we actually embrace them here! I have perfectionist coders (which is a blessing) and we learn something new every time. Thank you for the time and effort."
Coding Manager
Health & Surgery Center in Texas
"I wanted to tell you that you all WOW!'ed this group for sure! We were so impressed with the exit conference. HIA consultants keep it real, down to earth and fun! I will be happy to be a reference for any and all that are interested!"
Director of HIM
Community Hospital in Massachusetts
"I usually don't go out of my way to send a compliment, but in this case it is deserved. [HIA Coder] has far exceeded all expectations – attitude and productivity. If we could have ten more just like [her], we would. "
Coding Manager
Teaching Hospital in Washington
"We have had a wonderful experience working with your management staff and your coders! HIA has a well put together program that is heavy on education, your coders are always dependable and responsive to communication. You all put a lot of time into developing coder's skills with performing the quality reviews and we appreciate your efforts and look forward to continuing this relationship."
Director of HIM
Children's Hospital in Ohio
"Your team is helping us move forward with process improvements and ensuring our coded data is accurate and of top-notch quality [...] your reviewers have set the gold standard of what a consultant should be. They are both currently performing focused reviews on 100% of the work performed by a couple of coders not meeting our metrics to assess where those coders stand. Their work is very thorough and both are well rounded and bring a great deal knowledge within the coding field with them. I really appreciate having them with us."
Director of Coding
Large Health System with multiple locations in Georgia
Every year, the Centers for Medicare and Medicaid Services (CMS) announce key updates to the Hospital Outpatient Prospective Payment System (HOPPS) and the Medicare Ambul...
In the world of medical coding audits, choosing the right type of audit is crucial for aligning your organization’s objectives with your compliance, accuracy, and financi...
Recrudescence of stroke, also called stroke mimic, is the temporary return of neurological deficits that have previously resolved, in the absence of new damage/stroke, in...