We are skilled in identifying missing conditions 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.
capabilities. You can use our service for short basis such as when your coders are in vacation, or to reduce a backlog.
We offer a great coding & billing services at 4.5% (*certain conditions apply). Flat fee pricing also available upon request.
Proper coding is important for the success and compliance of MRA. Some practices outsource the coding and billing of provider’s note to our certified coders.
When the progress notes are received, they are coded in a timely manner and, depending on the contract, Symbion can even submit the encounters to the health plans.
Based on your need, you can spread the load between our coders and your own internal coding personnel. That is why we have simple process tailored to your need that facilitates the allocation of workload.
Clinical Documentation Improvement
HCC codes ensure that payments are risk adjusted based on the history and complexity of a patient’s health. And, based on this, Risk Adjustment Factor (RAF) scores are created that help calculate the reimbursement for each member. With the huge increase in the number of members in the Medicare Advantage Program, precise HCC coding has never been more important in the workflow of clinicians.
In addition, accurate HCC coding can help achieves many benefits such as: creating more holistic images of the complexity of a patient population, improving the value of problem lists and allowing a better management of chronic diseases of a patient. Better documentation that captures the total complexity of the patient often results in a more appropriate reimbursement.
That is why, we incorporate clinical documentation improvement service in our chart review and Medical coding and billing services to ensure that you get more accurate reimbursement for your population.
Symbion Coding, Inc Has Helped Clients :
- Uncover Hidden Revenue Of $1M+ Per 1000 Patients
- Capture More Accurate HCC Coding With Minimal Workflow Disruption
- Discover New Diagnoses
frequently asked questions
Yes, you can try the service for free (absolutely free) so we can do an initial assessment for you and let you know if you are leaving money on the table or not.
Absolutely, you can use us for specific project so your coding staff can focus in regular responsibilities. You can use Symbion if your staff is on vacation or unable to work for certain amount of days.
You don’t have to sign any long-term contract. The contract length will depend on the scale of the project.
We have a large pool of coders in our network in most of the states in the U.S. We only hire coders who are based in the U.S.
No, our coding operations are based on the continental U.S. only.
We offer value pricing and for the most part it is lower than our competitors.
There is no penalty to cancel the service. Just give us 2-4 weeks’ notice.
- More accurate HCC Reimbursement: Because of our expertise, your medical practice, MSO and ACO will get a more accurate HCC reimbursement.
- Less Headaches: The complexities of medical coding and billing are constantly growing. Symbion Coding responsibility is to monitor changes in coding guidelines, payment policy and regulations so you don’t have to.
Less Overhead: No need to hire a trained specialist and pay a fixed cost for salary, benefits and real estate space.
Our accuracy rate is above 95 percent
We handle all types of coding or chart review projects such as HCC coding, HEDIS, CPT and HCPCS coding. We also have experience in full chart review or sweep project for CMS data submission.