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.
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:
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Review applicable denied and/or rejected claims
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Determine if an appeal is warranted
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Facilitate appeal process including authoring of appeal letter, tracking and adjudication
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Analysis of denials and operations assessment to determine root causes.
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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.
