Inpatient audits can be targeted by DRGs, a time period or a specific clinical condition such as heart failure. Outpatient audits can focus on Lab, Radiology, Observation, Ambulatory Surgery, Emergency Room, ER E/M for Professional, or ER E/M for Facility. Our audits will validate the quality and accuracy of coding assignments with any trends identified and reported.
Our revenue integrity solutions review the coding and clinical documentation for compliance with applicable CMS regulations and guidance with consideration of your hospital’s specific coding policies.
The BESLER auditing and compliance review will identify areas for process and documentation improvements that will help ensure successful reimbursement under the Medicare Prospective Payment System.
The audit includes a written summary report of the findings as well as a call to reconcile any questions related to the audit findings. On-site education is available at an additional cost.
Why Choose BESLER?
- BESLER’s proprietary software maximizes productivity through workflow automation and intensive data mining.
- No need to learn new software or research complex potential edits.
- QA oversight ensures that claim touches are meaningful and increase speed to resolution.
- Seamlessly interfaces with your staff and systems to bolster internal staff and support management.
- Careful matching of our coding experts (average of 15+ years’ experience) to your organization’s unique needs.
- BESLER’s coding analysts have various certifications, including MHI, RHIA, CCS, CDIP, CICA, and some hold AHIMA-Approved ICD-10-CM/PCS Trainer status.
- Identification of improvement opportunities with expert instruction to prevent repeatable errors.
- Extensive reporting of findings catches potential compliance issues before they become large problems.
- Real-time dashboards and final in-depth analytics reporting provide information about recovery efforts to facilitate customer oversight.
If anything is being missed in your internal or external audits (revenue or compliance risks), we will find it.
Contact BESLER to help your hospital improve coding quality and lower potential risk and costs.