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Outpatient PPS Compliance Coding Perform a prospective or retrospective review of a sample of Institutional outpatient claims and the corresponding medical record documentation to assure complete charge capture, accurate coding and documentary support for claimed services. This includes a focus on both revenue optimization and compliance with PPS requirements to avoid overpayment. Perform a review for accurate capture of "Pass-Through" services, other additionally billable services and appropriate modifier utilization, assuring maximal revenue. Perform a review for compliance with "Outlier Payment" requirements While a review of accurate and complete Diagnosis Coding is standard to all reviews, a focused review on diagnosis coding is available as an add-on or stand alone engagement. Coding: per diem and "backlog" coding services are available by AAPC certified coders Our Coding Helpline to answer coding/billing questions is available with a 24 hour response time in most cases. “Documentation & “Charge Capture Templates Claim Denial, Suspend and Reduction review to assess problem areas and identify solutions as well as preparation of Re-submissions & Payer Appeals. A "Shadow Review service for Third Party Payer "Medical Claim Review" is available as an add-on or stand alone engagement. Litigation Support in Medicare
fraud/abuse actions Billing seminars on outpatient PPS services. "Update Seminars" focusing on regulatory change All seminars are available on videotape Additional services available
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