medical coding capablities
TRANSCRIPT
2014
Xertz Business solutions Pvt Ltd
10/23/2014
Xertz Service Capabilities
Table of Contents
1. About Xertz ........................................................................................................................................... 3
2. Why Xertz?............................................................................................................................................ 3
3. Service snapshot ................................................................................................................................... 4
4. Physician coding services ..................................................................................................................... 4
5. Hospital coding services ....................................................................................................................... 5
6. Other coding services ........................................................................................................................... 5
6.1 HCC coding .................................................................................................................................... 5
6.2 HEDIS Review ................................................................................................................................ 6
7. Client Systems Expertise ...................................................................................................................... 7
8. Contact us ................................................................................................................................................. 7
1. About Xertz
XERTZ – a Healthcare services organization dedicated to serve the need of Healthcare Industries
through committed and reliable services.
Our “right” skilled resources, enhanced process, excellent quality and turnaround time helps us
to deliver the best services to our clients and differentiates us in healthcare industry.
XERTZ is committed to provide better career for the Healthcare Professionals and empathetic
service to our customers.
2. Why Xertz?
Xertz Management team has over 15+ years of experience in healthcare services and has served
clients in various specialties and scopes.
Better understanding of scopes and services
Alignment of process towards client needs
Cost effective operational model
Open communication and customer engagement
Process control and best work flow
Performance tracking and continuous improvement
3. Service snapshot
4. Physician coding services
Seasoned coding professionals with hands on experience in various physician coding specialties
which includes but not limited to Radiology, Pathology, Emergency room, Surgery, Anesthesia, Pain
management, Internal medicine, Neurology and cardiology provides coding support for our clients
of physician groups
Process flow – Physician coding
Ph
ysic
ian
Co
din
g
•Radiology
•Pathology
•ED
•Surgery
•Anesthesia
•Pain Management
• Internal Medicine
•Neurology
•Cardiology
Ho
spit
al C
od
ing
• Inpatient DRG
•Same day surgery
•ED
•Clinics
•Ancillary & diagnostics
Oth
er
Co
din
g Se
rvic
es
•HCC coding
•HEDIS review
Medical Records
- Client system or
SFTP
Code Assignments
- Billing system
- Coding interface
Quality check
- By designated QC
- Sample size to be determined based on quality trends
Output
- Export / abstraction of codes
-Coding information in desired format
-Documentation deficiencies shared for provider education
5. Hospital coding services
Facility / Hospital coding professionals with good experience in various work types including but not
limited to Inpatient – DRG coding, Same day surgery, Clinics, Emergency room and Ancillary /
Diagnostic coding provides coding services in various hospital systems.
Process flow - Hospital coding
6. Other coding services
6.1 HCC coding
Hierarchical condition category coding being complex in nature and requires very good
clinical knowledge and multi specialty exposure for accurate reporting of HCC codes. Our
team of HCC coders has 2+ years of experience in HCC coding for different Medicare plans.
Medical Records
- Hospital document management system
Code Assignments
- 3M encoder
- Billing system
Quality check
- By designated QC
- Sample size to be determined based on quality trends
Output
- Abstraction of codes
- Printing coding summaries
Process flow – HCC coding
6.2 HEDIS Review
HEDIS review of clinical measures is performed by abstractors who are basically paramedical
and life science graduates with good clinical knowledge. In addition, they are trained in Medical
coding guidelines as well which helps them to abstract the clinical information from medical
records accurately.
Process flow – HEDIS Review
Medical Records
- Retrieval for reporting period
- For all members of the plan
Workflow
- Batched and scanned to client system
HCC Assignments
- Review of medical record for reporting period
- Captures appropriate HCC code
Output
- HCC codes submitted to CMS by Plans for RAC audits
Medical Records
- Scanned and loaded to client system
Process
- Coder / abstractor reviews medical records
- Abstract relevant information applicable for measure
Output
- Report whether the measure has passed with required details
7. Client Systems Expertise
Our coders & Leaders have experience in various coding interfaces and billing systems. The
below list includes the different platforms that our staff worked so far…
Coding / Billing systems
RDX HMS
Citrix Cerner
Powerchart Mckesson
EPIC A-Life
Onbase Medsuite
HPF Meditech
HDM TES
3M Centricity
8. Contact us
Xertz Business Solutions Pvt LTD
No: 107 B, LDG Road
Little Mount
Saidapet
Chennai-600015
India No: 044-65623575, 044–65557787
US No: 1-239-344-7857, 1-215-240-8300
Email id: [email protected]
www.xertzsolutions.com