Accurate medical coding is crucial to confirming compliance and protecting revenue integrity. JHMCI Coding Audit Services help you identify and address existing weaknesses in your clinical documentation and coding processes by delivering:
Market-leading coding audits from experienced professionals
Comprehensive reporting for root cause analysis and staff education
Rapid, sustainable ROI in confirmed compliance
JHMCI is a true partner that takes the time to understand your unique medical coding audit and consulting challenges by delivering sound coding reviews and recommendations, providing actionable plans, and supporting with the necessary resources and management team that is there for you.
Our core strengths provide robust revenue integrity and compliance benefits that help minimize risk and enforce coding standards. We deliver on these strengths, while optimizing reimbursements and minimizing coding denials.
Our Experience
JHMCI has certified auditors with expertise in a number of chart types and specialties that include inpatient, outpatient, same-day surgery, E/M, multiple surgical specialties, emergency department, observation, ancillary, recurring, as well as diagnostic and interventional radiology. Our auditors have deep experience with facility, pro-fee, and risk adjustment coding.
We have completed hundreds of audits and consulting engagements that have helped a variety of facilities and practices ranging from small physician practices or community hospitals to large, multi-facility health systems and comprehensive multi-specialty provider practices.
Coding audits, which are the validation of code assignment against the supporting clinical documentation and coding guidelines, are instrumental in ensuring coding accuracy. Healthcare facilities and providers usually conduct regular coding audits as directed by their internal compliance plan, and this usually consists of a random sampling of records during a specified timeframe, typically on an annual basis. While compliance plan-driven audits are beneficial, healthcare facilities and providers should not assume that additional audits are not useful or required.
JHMCI offers comprehensive audits of coding-related practices that are aimed at improving coding accuracy, thereby minimizing coding compliance risks and reducing coding-related denials.
Compliance Auditing Approach
An audit sample selection can be focused on areas that pose risk, and identify opportunities that impact revenue and quality. Sample selections can also be based on one or a combination of the following elements:
Coder
Patient-type
High cost cases
Denial patterns
Service lines
OIG/RAC focus
Our experienced and credentialed auditors keep abreast with the latest coding guidelines and requirements to ensure that audits are accurate, consistent, and compliant. Audits are also completed according to facility or provider as well as state or payer specific guidelines so that results show a true measure of compliance, and help to identify areas where improvement may be needed.
Reports can also be customized according to client needs with detailed reports that are used to support results-driven coding staff education. Our mid-level managerial reports provide the recommendations needed to carry out an improvement plan, and our high level executive summary includes just the right amount of detail for presentation to senior leadership.
JHMCI stands behind its audit and consulting solutions. We deliver this commitment through the following:
Certified coders and auditors – AAPC or AHIMA accredited
Supportive management staff to coordinate services and minimize the impact on your teamType your paragraph here.