The implementation of the Affordable Care Act (ACA) significantly expanded healthcare access for all Americans, leading to changes in the budgeting and spending strategies of healthcare systems. Given the current economic constraints, staff shortages, and the need to meet growing demands for healthcare services, Medicare/Payer have adopted a more stringent approach. As patient and physician preferences continue to rise, the home health sector is primed for further growth.
Introducing Clinix, a revolutionary solution that empowers our clients with enhanced accessibility, affordability, and unlimited reach to their financial KPIs, RCM, and Clinical Compliance dashboards.
Our state-of-the-art technology transforms the home health sector, enabling us to deliver dependable AI-powered solutions through user-friendly digital experiences to our valued customers.
Coding is a small, but essential part of the revenue cycle, and often the most intimidating. When this pace slows down, revenue cycle performance is impacted. If backlogs pile up, you risk missing the timely filing deadlines set by payers.
There is a lot to take your focus away from your primary concern – the patient.
The Coding and Documentation Review is an in-depth review of medical record documentation and claims coding that identifies deficiencies and areas of risk. This review will help streamline coding and documentation processes and decrease the risk of external audits.
Avoid unnecessary clutter on your revenue cycle desk. Learn to track your coding patterns and reduce the risk of an audit due to over-coding, or lost revenue due to under-coding.
Let our clinical experts become part of your team to carry out clear, consistent, complete, reliable, legible, precise, and timely clinical documentation services to ensure the reimbursement and compliance you’ve earned while improving patient outcomes.
Chronic conditions such as heart disease, diabetes, hypertension, arthritis, and cancer require ongoing monitoring, medication management, lifestyle modifications, and coordination among healthcare providers to improve the quality of life of patients and provide optimal outcomes. At Prohealthqa, we specialize in providing chronic care management services to address these conditions and more. Our approach encompasses continuous clinical monitoring and care coordination while delivering customized solutions and personalized care plans to meet the needs of different health agencies and patients.
With ICD-10 implementation, increases in government audit from Recovery Audit Contracts (RAC) and other auditors, and Centers for Medicare and Medicaid (CMS) initiatives such as Hospital-Acquired Conditions and Value-based Purchasing that rely on medical record content, it is imperative that providers are as accurate as possible. Furthermore, it may end up serving as a legal document to verify the care provided in several circumstances.
Good clinical documentation improves the quality of care, supports better communication, and reduces claim denials. Enhance your current CDI program with flexible and built-to-suit CDI services guided by highly skilled and passionate medical professionals.
Our competent professionals are experienced in reviewing medical documentation and notifying the physicians of inaccurate documentation.
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