Chart Reviews done for coding education and documentation Improvement.
Gap Analysis (documentation vs coding).
Remedial Help (Coder/Physician Education including Template modification).
Average RAF scores improved from 0.5 to 1 - 1.25 (Medicaid).
Claims Management - Process Innovation and Technology Result in Cost Reductions
The Challenge: Prohibitive labor cost and considerably higher turnaround time due to large number of manual adjudications resulting from mismatched information between enrollment data and provider data.