Process Review
For Revenue Recovery & Optimization

Revenue Optimization & Staff Augmentation for a Major Health System

Challenges

Our client, a major university health system, was looking to optimize revenue. They had millions of dollars on hold as the claims hit the clearing house due to improper coding, POS and modifier issues, demographic mismatch, etc. Providers may have given illegible medical reports which prevented the coders to code with highest specificity. Unavailability of experienced staff created a backlog which caused revenue leakage. Clearing the denials within the TFL was another challenge due to the shortage of expert coders.

Solution

Vee Technologies expert team worked on the charts and gathered the areas where provider education was required. We assisted the client on revenue enhancement, if properly documented, by coding with highest specificity. Working on clearing the claim edits based on the CMS, NCCI and LCD/NCD guidelines helped the maximum number of accounts go out the door. Our denial experts reviewed the EOB of denied claims and provided the appropriate coding decision which helped the timely resubmission of claims.

Vee Technologies provided sufficient experienced staff to the client to clear the backlog.

Results

Appropriate action taken on clearing the claim edits and denials helped to drop the huge backlog. This resulted in additional revenue recovery. Coding to the highest level of specificity helped increase the payments in ED accounts.

Vee Technologies followed complaint and transparent process to achieve our client's goal.

In these unprecedented times, Vee Technologies is committed to doing our part to help those in need. With the ongoing spread of COVID-19 (coronavirus) and the incredible speed at which things are changing around us, organizations are continually adapting their operations and business structure. Vee Technologies has the experience and capability to help your organization through this difficult time. We've expanded our continuity plan and infrastructure to accommodate the current business needs. Please do not hesitate to contact us when your need arises, our implementation team can have you up and running quickly and efficiently.

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