HSMN assesses the entire Revenue cycle including the clinical documentation of the Medical staff, the members of the Revenue Cycle team from initial patient data collection through the claims process. We analyze claims data against our data base to see if claims have been made or missed for services provided that we know are reimbursable. Our clients have reaped the benefits of millions of dollars and improvements to each of the processes within the Revenue Cycle.
We have specialized in working with hospitals who have implemented Enterprise wide systems such as Epic to determine which of the work queues are holding up claims processing. Which work queues can be eliminated and cleaning them up with our certified coding staff. In the academic medical centers in which we have worked to date, our process has been a grand success. There is no black box but hard work of looking at data, data sources, systems issues and anyone or anything who is in the Revenue Stream
We have teams of coders (ICD 10 Certified trainers) who are working with both the medical staff and the coders to create closer links between specificity of the documentation and the critical thinking skills needed by coders to create a clean claim. It is not only about the software but about the judgments that are made by staff and the data used.
Post Epic Implementation and ICD 10 transition are going to result in 2-4% decline in net revenue over the next two years and now is the time to make sure Work queues are not going to complicate the already difficult task of transitioning from ICD 9 to ICD 10 without loss of revenue.