We are skilled in identifying missing conditions in prospective and retrospective review that can be found in the medical record which can maximize reimbursement.
Our experience HCC coders focus on three areas:
1. Documented diagnoses adjusted for risk that were incorrectly coded using codes not adjusted for risk. In this aspect, we will submit the correct codes to the health plans.
2. Incorrect risk adjusted diagnoses that were reported to health plan will be removed from the patient risk profile. In this case, provider approval may be needed depends on the health plan before these incorrect codes can be removed. Also, we will share our feedback with the provider to avoid making similar mistakes in the future.
3. Inferred conditions or clinical indicators found in medical records will be compliantly queried. If agreed by providers and documented during or after face to face encounters with patient, these newly found diagnoses will be submitted to health plan.
At Symbion Coding, Our Process Is To Capture, Correct And Validate Risk Adjustment Diagnostic Codes To Ensure That Our Clients Receive Accurate Reimbursement From CMS For Your Member Population. We Can Handle Big And Small Project.