Who we work with

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WHO WE WORK WITH

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Medical coding audits and coding are essential in several healthcare settings to ensure accurate documentation, coding compliance, and appropriate reimbursement. These settings include hospitals, where HIA conducts audits and provides coding support for both inpatient and outpatient coding across various departments such as emergency rooms, surgical units, radiology, and laboratories.

Physician practices, including primary care clinics and specialty clinics, also require coding audits to ensure accurate coding of procedures, diagnoses, and services. Ambulatory Surgical Centers (ASCs) also rely on coding audits to maintain proper billing and compliance. 

Partnering with a quality medical coding and auditing company is vital role in maintaining accuracy, compliance, and appropriate reimbursement in various healthcare settings.

 

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.

 
WHAT WE OFFER

Our niche solutions

Total Outsource Coding Support

Single Path Coding

Interim Auditing

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.

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