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WHAT WE OFFER

Our niche solutions

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

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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

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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

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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  

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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 

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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.

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