Ensure your coding department is operating at peak efficiency and accuracy. Uncover problem areas –from physician documentation, to code compliance, and beyond. Reduce claim denials and get paid accurately for the care you provide.
From ICD-10 to changing government regulations, code audits and continuing education is more important than ever. Do not settle for code compliance. Strive for coding excellence. CPJ’s completely customizable code audit and education services can help.
Audits are performed by expert coding specialists trained in specific service lines and backed by a company which specializes in end-to-end revenue cycle management. Identify problem areas throughout the revenue cycle that lead to coding inaccuracies, and contribute to revenue loss.
Every hospital and health system are different and their needs are unique. Augment your current CDI program with flexible and built-to-suit CDI services guided by highly skilled and passionate medical professionals. Our competent professionals are experienced to review medical documentation, and help advise the physicians in accurate documentation. Improve performance and ROI along with a variety of other benefits.
A CDI specialists job is to ensure the physicians’ documentation is complete and accurate regarding a patient. They can even help the physician determine what DRG the patient has, although it’s ultimately up to the physician. A coder, on the other hand, takes what is documented and assigns a code. Often, a coder can catch errors in documentation, but if a CDI program is in place, this should happen less often.
CPJ’s remittance processing professionals not just process payments but provide you trends and understanding on reasons for denials, prior-authorization, non-covered services, quality of your clinical documentation and coding processes, and effectiveness of your front-end patient collections.
Electronic remittances typically contain a high volume of payment transactions. The processing of ERA batches involves loading the files into the revenue cycle system, processing exceptions from the batch runs by making due corrections using the functionality available on the revenue cycle system .
Payment information from scanned images of Explanation of Benefit (EOB) documents is captured and each line item is posted to the respective patient accounts. By developing practice and physician-specific business rules along with our team, you will be able to ensure accurate payments, adjustments, write-offs and balance transfers.
Our staff is conversant with ANSI denial codes as well as the remark codes used by different payers. We post denials into the customer’s practice management system and take actions such as billing the secondary payer, transferring the balance to the patient account, making adjustments/ write-offs as per defined policies, and routing the denied claims to appropriate work queues.
Patient payments should be accounted in order to properly close the claim and avoid any inflated AR. We have extensive experience in processing payment received from patients via different channels like POS cash collections, checks and credit cards (patient portals). Our payment processing professionals account for patient payments, make decisions on transferring any pending balances to secondary insurers, and resolve any credit balances.
AR is an important piece of the revenue cycle.Efficient rejection handling helps to identify any loop holes in the electronic billing system faster & enhances the effectiveness of electronic claims submission.We identify trends in billing leading to reduced denials and appeals are completed keeping a close eye on AR Outstanding Days for accelerated reimbursements.
Professional and timely credit balance handling is essential to keeping a positive relationship with patients, insurance companies, and other payers. Leverage CPJ’s relationships and proven best practices to keep your customers happy.
Our Provider Enrollment services enable practices to get enrolled for the services they provide by ensuring that payers have the data they need to process claims for the services you provide. We constantly monitor the payers to ensure applications are received and processed on time. We work diligently to identify and resolve potential administrative issues before they impact your provider reimbursements.
Our Provider Enrollment services enable practices to get enrolled for the services they provide by ensuring that payers have the data they need to process claims for the services you provide. We constantly monitor the payers to ensure applications are received and processed on time. We work diligently to identify and resolve potential administrative issues before they impact your provider reimbursements.