Markets we serve

Markets we serve

Hospitals

• Case Mix Index (CMI) dropping? Insufficient documentation and inaccurate coding can lead to a decrease in CMI. Partner with HIA to replace underperforming coding vendors or to perform a focused coding audit to optimize your CMI.
• Increasing payer denials? Lack of available (or inexperienced) resources to review can lead to a backlog in addressing payer denials. Partner with HIA to replace underperforming coding vendors or have us assist with your Denial Management. 
• Increasing in billing edits? Many facilities are facing an increasing volume of billing edits. HIA can identify the root cause and mitigate future edits.  
• Failing quality measures? Coding has the ability to adversely impact your quality measures. Partner with HIA to ensure that you have complete and accurate coding.

Physician Groups

• Are your providers documenting appropriately to meet current guidelines? Guidelines change on a frequent basis. Partner with HIA to do an initial review of your documentation and see if your physicians need further education.
• Who assigns the codes at your facility? Depending on who assigns the codes (physician, coder, or both) there may be differing areas of opportunity. Partner with HIA to determine if your coding is optimal and if you are being reimbursed appropriately.
• Does your coding accurately reflect patient acuity? Capturing the appropriate HCC codes can affect the RAF score and your overall reimbursement. HIApro reviews and assigns all relevant codes to accurately reflect the patient.  
• Are you up to date on your Incident To and Shared Visit guidelines? The CMS guidelines for Incident To and Shared Visits have been updated. Partner with HIA to ensure your coders and providers are complying with the new guidelines. 

Ambulatory Surgery Center

• Are you getting the correct reimbursement for your procedures? Even for the most experienced coder, advanced CPT surgical coding can be a challenge. Our coders are credentialed, trained and reviewed to ensure coding is accurate the first time.
• Are your coders up to date on the newest guidelines and applying them correctly? With yearly CPT coding updates, it can be hard to keep up with all of the new coding guidelines. Partner with HIA to perform a review and see if your coders need any further education.
• Does your coding reflect the severity of the patients you are treating? Coding to the correct specificity can affect your facility's reimbursement. HIA coders assign all relevant codes to accurately reflect the severity of the patient.  
• Are your coders following the changes being made to the LCDs and NCDs? The LCD/NCDs and bulletins are continuously changing and difficult to manage. Partner with HIA to perform a review and see if your coders need any further education.
• Do you give feedback to your providers on documentation opportunities? HIA Consultants can educate your providers on the importance of documenting and reporting appropriately.
  

Behavioral Health

• Are your providers documenting treatment time appropriately? With time-based codes, poor documentation can affect reimbursement. HIA Consultants can educate your providers on the importance of documentation and accurate coding.

Critical Access

• Increase payer denials? Lack of available (or inexperienced) resources to review can lead to a backlog in addressing payer denials. Partner with HIA to review those denials to confirm that they are truly a coding error and determine if they can be appealed.
• Increasing in billing edits? Many facilities are facing an increasing volume of billing edits. HIA can identify the root cause and mitigate future edits.  
• Failing quality measures? Coding has the ability to adversely impact your quality measures. Partner with HIA to ensure that you have complete and accurate coding. 
• Do you give feedback to your providers on documentation opportunities? HIA Consultants can  educate your providers on the importance of documenting and reporting appropriately.     
   

Urgent Care

• Are your providers documenting appropriately to meet current guidelines? Guidelines change on a frequent basis. Partner with HIA to do an initial review of your documentation and see if your physicians need further education.
  
• Who assigns the codes at your facility? Depending on who assigns the codes (physician, coder, or both) there may be differing areas of opportunity. Partner with HIA to determine if your coding is optimal and if you are being reimbursed appropriately.
• Does your coding accurately reflect patient acuity? Capturing the appropriate HCC codes can affect the RAF score and your overall reimbursement. HIA reviews and assigns all relevant codes to accurately reflect the patient.  

Rehabilitation Centers

• Do you give feedback to your providers on documentation opportunities? HIA Consultants can educate your providers on the importance of documenting and reporting appropriately.

Rural Health Clinics

• Are your providers documenting appropriately to meet current guidelines? Guidelines change on a frequent basis. HIA coders and consultants are specialized in coding for Rural Health Clinics and understand the unique RHC guidelines.
  
• Who assigns the codes at your facility? Depending on who assigns the codes (physician, coder, or both) there may be differing areas of opportunity. Partner with HIA to determine if your coding is optimal and if you are being reimbursed appropriately.
• Does your coding accurately reflect patient acuity? Capturing the appropriate HCC codes can affect the RAF score and your overall reimbursement. HIApro reviews and assigns all relevant codes to accurately reflect the patient.  

Home Health

• Are your providers documenting appropriately to meet current guidelines? The new reimbursement model for Home Health brought an entire new set of guidelines and there will surely be additional changes in the future. Partner with HIA to do an initial review of your documentation and see if your physicians need further education.
• Are your coders reporting to the correct Clinical Grouping? Reporting to the correct HHA Clinical Grouping can impact your overall reimbursement. HIApro coders assign all relevant codes to ensure you are being reimbursed appropriately.