Overview

With increasingly complex government legislation, regulations and investigations, hospital systems continue to struggle to ensure complete, compliant, and accurate documentation and coding practices. Our approach is through heavy primary and secondary level reviews in order to minimize risk and regulatory exposure. Not only do we ensure accurate and appropriate reimbursement, we are diligent in coding quality compliance.

Value

Accuracy

Accuracy

  • Accurate MS-DRG and APR-DRG assignment supporting case mix index (CMI) and reimbursement
  • Accurate reflection of severity of illness (SOl) risk of mortality (ROM)
  • Utilization of secondary, tertiary reviews by our highly skilled team of on-site and remote coders
  • Best-in-class audit and education program; full collaboration and partnership with clinical documentation improvement staff and provider team

Support

Support

  • Support of medical necessity for services rendered
  • Support of decision to admit/medical necessity for inpatient status; correct place of service status
  • Compliance with State and Federal compliance regulations
  • Support of resource consumption and length of stay
  • Management of in-patient condition identification and coding

Improvement

Improvement

  • Reduction in the number of rejections and denials, including Hospital Acquired Condition/Present on Admission concerns and discharge disposition issues
  • Reduced penalties related to 30-day re-admissions; the excess readmission ratio includes adjustments for factors that are clinically relevant, including comorbidities

Outcome

ACCDS’ team of expert physicians and coders perform both concurrent and retrospective reviews for their clients. We focus on quality, and ensure that reimbursement is appropriate for the services and documentation provided. Additionally, our quality assurance program supports continuous learning through education to the hospital providers, clinical documentation, and coding staff.

Coding & QA Team

The implementation of ICD-10 offers a wealth of information to the US Healthcare System. Around the industry, however, I have not seen a plan to move beyond the traditional processes of ICD-9. ACCDS’ forward-looking vision for driving successful change will impact the quality of care and ensure that the provider is appropriately reimbursed for the care they provide.

Brian Dessoy

Brian Dessoy

EVP, Coding & QA

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