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Medical Coding & Auditing Services

 

 

We offer a full complement of Medical Coding and Auditing Services to help you optimize your reimbursement and enhance your productivity. PHS offers services to help maximize workflow, enhance productivity, improve revenue, realize cost savings and increase compliance.

Medical Auditing Services

We offer a full complement of Medical Auditing Services to help you optimize your reimbursement while maintaining compliance with regulations. We will identify the strengths and weaknesses of your coding, documentation, billing and reimbursement practices to identify and report opportunities for performance improvement. Once areas are identified, we can customize coder and physician education and training to boost your compliance rate. Our auditors are AHIMA credentialed, and each auditor has over 15 years of experience.

Pyramid’s wide range of expertise in Medical Auditing Services includes:

  • IM Internal Audit
  • MS-DRG Validation Audit
  • APC- Audit
  • Physician Office (Pro-Fee) Audit
  • Interventional Radiology Audit
  • Cardiovascular Audit
  • Chargemaster Audit
  • OIG High Profile Cases Audit
  • Itemized Charge Detail Audit
  • DRG Review to include Pre and/or Post Bill
  • RAC Audit and Appeals
  • ICD-10 Review
  • Nationwide Staffing/Education/Training: Quality AHIMA Credentialed Staff

Optimizing Performance: Helping You to Increase Your Performance

  • Executive Reports
  • Action Plan for all cases with recommendations and reimbursement impact.
  • Summary of Findings
  • Financial Impact Report with original reimbursement and revised reimbursement for each case.
  • Detailed Diagnosis Report for cases with variances.
  • Detailed APC Report for cases with variances.
  • Detailed DRG and APC Claim Report with all auditor comments for cases with variances.
  • Policy and Procedure-Review & Development

Hospital Audit Services Types

  • Inpatient (Includes Medical/Surgical, Cardio, NeuroCare)
  • Audits Pre/Post ICD 10 Implementation
  • Same Day Surgeries/Observations/Outpatient services
  • Radiology: Diagnostic and Interventional
  • Emergency Departments
  • Hospital-based Clinics
  • Facility E&M

Physician Audit Service Types: CPT and HCPCS Coding

  • Surgeries
  • E&M (including Office Visits, Preventative Visits, Observations, Inpatient Services, Consultations and Emergency Services)
  • Inpatient Pediatrics
  • Critical Care
  • Newborn Services
  • Diagnostic Procedural/Surgical Services

Medical Coding Services

Whether you need on-site or remote services, flexibility in scheduling or assistance with a long-term or short-term special project, our highly trained and credentialed staff is here to help. Our expertise spans all types of healthcare organizations from Academic Medical Centers to Long Term Care Facilities and Physician Groups. See why so many of our clients return time and time again.

Partnering with PHS for Medical Coding Services has noticeable benefits:

  • High quality, accurate coding and abstracting services
  • Streamlining coding operations
  • Improved revenue stream
  • Improve CMI which in turn improves DRG-based revenues
  • Reduce DNFB and/or HARA levels
  • Reduce impact of coder retention/vacancy challenges
  • Reduce lost revenue
  • Reduce/prevent backlogs
  • Overflow coding support
  • Flexible pricing solutions: Onshore and Offshore Staffing Models
  • HIPAA Compliant software and billing practices
  • Expertise in all Hospital Coding Service Types
  • Expertise in all Physician Coding Types: CPT and HCPCS Coding
  • Credentialed staff including RHIA, RHIT, CCS, CCS-P, CCA, CPC, and/or CPC-H.

Contracted Medical Coding Solutions (Outsourcing)

Our expertise in Contracted Medical Coding Solutions (Outsourcing) is the answer to your staffing shortages and improving your DNFB.

Medical Coding Support - Onsite and Remote

Our expert onsite and remote medical coding support services are available for long-term coding assistance or short-term backlogs. Our remote coding resources utilize a secure Internet technology that allows documents to be accessed electronically. We work with your IS department to gain appropriate access to your facility's imaging, encoder and abstracting systems.

Contact Pyramid Healthcare Solutions today for more information about our medical coding and auditing solutions.

PDFCoding Services Printable PDF