Profee Coding and Review Services
Profee Solutions
Here at HIA, we understand the value of supporting all providers, and HIApro focuses on just that. HIApro is a professional fee consulting service. Our service identifies specific areas of compliance and financial risk, provides pertinent information and educates clients on proper coding, billing and documentation practices. Our main objective is to build long-lasting relationships with physician practices.
WHO WE WORK WITH
Markets we serve
WHAT WE OFFER
Our niche solutions
Total Outsource Coding Support
Single Path Coding
Interim Auditing
We provide experienced coding consultants when you need them most:
Rev Cycle Management
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.