HIM International Solutions
Harmony has a partnership with a reputable company that allows us to provide international solutions. This is a solution we could recommend based on a comprehensive review and some of the key components of our offshore program listed below.
We have a robust Quality Assurance process that is mapped to the entire coder lifecycle.
The key features are:
- Our QA Program is designed to assure our customers of ‘better-than-SLA’ standards of performance and is based on Lean Six Sigma principles and methodologies
- All audits and remedial processes are tightly integrated into operations
- We have a dedicated pool of Quality Analysts who are coding experts with demonstrated proficiency in high quality coding and are trained on various cutting edge QA tools and processes
- Daily audits and detailed feedback sessions are conducted based on error categories to ensure remedial action is incorporated real-time
We have a proprietary Quality Management tool that helps us manage the entire QA process – these include setting the QA policy parameters, assigning audit queues to quality analysts, re-assigning problem charts to coders, generating various quality assurance reports, and more.
In case a coder does not show improvement in his quality scores during the 100% audit session, he/she will be moved out of operations and provided in-depth remedial coaching for a maximum of 3 business days. On scoring a minimum of 95% in the remedial quality assessment, he/she is moved back into operations with the relevant sampling audit schedule. If the score is below 95%, the coder is permanently removed from operations and managed out of the company for poor performance.
QA Documents and Reports
Our QA tool allows us to pull several types of reports (both standard and by custom data fields).
Some examples include:
- Standard reports – e.g. daily, weekly and monthly reports
- Custom reports – e.g. drill down reports by specific data elements such as: by provider selection, by diagnosis, by E&M, by procedure, by modifier etc.
For remedial action, we also use a form called the ‘Performance Improvement Plan (PIP)’. This allows us to document the nature of performance issues along with the timelines agreed upon to improve the quality scores and performance standards.