Compliance

Increased exposure to financial risk and penalties

 

As the federal government continues to pursue healthcare organizations to ferret out fraud and abuse, healthcare organizations must not only be vigilant in implementing, maintaining, and updating their organization’s compliance programs, they must also ensure accurate and complete coding.

The current climate of government scrutiny in healthcare dictates the need for adherence to accurate coding and billing processes including relevant documentation of medical billing codes, and proper charging of insurers for medical services rendered. Patient care, data integrity, compliance, and reimbursement are at risk when the severity of the illness, treatment provided, and mortality rates aren’t documented and coded accurately.

Since the conversion to ICD-10, healthcare organizations are increasingly challenged with coding and DRG accuracy rates far below industry standards. In fact, in a recent study by Becker’s Hospital Review:

 

41%

Average outpatient coder accuracy was found to be 41 percent.

72%

Average coding accuracy for DRG codes was found to be 72 percent.

$754

Representing a net financial decrease of $754 per case.

 

Identifying incorrect coding is the key to driving compliance and decreasing fraud and abuse penalties

With the grace period now over and 6,000 new codes released, clearly continuous assessment of coder knowledge in ICD-10 and CPT coding, and education and training to address knowledge gaps is a need. Harmony Healthcare offers an undeniable value-proposition to healthcare organizations hoping to reduce risk. Investing in staffing and consulting solutions is a strategic way to maintain compliance. With the right partner, healthcare organizations are free to focus their time and money on what counts—the patient.

 

 

 


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HARMONY HEALTHCARE

A human capital management company, providing staffing and consulting solutions in Revenue Cycle Management and Population Health to a diverse range of healthcare organizations nationwide. The company’s portfolio delivers quality solutions to empower healthcare organization success, enhance clinical and financial outcomes, and enable the transition to value-based healthcare.

Location

2909 West Bay to Bay Blvd., Suite 500
Tampa, FL 33629
813-369-5159

Compliance Report Line:
813-369-5165
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