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Our consultant specialist can provide an assessment of the process as well as medical record review services for completeness of physician and clinical staff for documentation. Education can be provided to all staff. HMI Provides Physician Documentation Audit, Clinical Documentation Compliance Review and Audit, Improvement Program and Training Program for Healthcare, hospitals and physician practices who want to identify missing charges and improve documentation accuracy.

Clinical Documentation Audit, Physicians Compliance Review Nashville TN

Our coding specialists will perform a comprehensive review of the RAC findings cited in the demand letter, patient medical record, and corresponding final billed claim to determine if the hospital documentation and/or billing information is appropriate. Where applicable, this service can be expanded to assist the hospital in appealing the reason for denial of entire claim or specific services. HMI Provides Recovery Audit Services will perform a review of the RAC findings Medicare Recovery Audit Contractors, Medicare RAC Audits, Healthcare Compliance Audits to the Hospitals and Healthcare Providers.

Recovery Audit Contractor RAC Audit Findings & Appeal Services Nashville

Our consultant specialists will perform the claims reviews required under the Client’s Corporate Integrity Agreement (CIA), prepare required reports for the Office of Inspector General (OIG), make recommendations for Client’s corrective action plan and provide necessary staff training and education on current coding and billing methodologies. We also assess the providers billing and coding practices and compliance obligations under the CIA and Medicare rules and regulations. HMI provides medical billing and coding compliance and compliance program audit services, medicare compliance audit, claims audit, Independent Review Organization IRO Claims Review and Audit Services for compliance process.

Independent Review Organization IRO Claims Review and Audit Nashville

Our consultant specialists will perform a comprehensive review of the patient medical record to ensure that the IRF admissions were appropriate to meet medical necessity and the documentation and staff services satisfied the minimum CMS requirements. The review will confirm all the requirements for are met for completing the preadmission, physician admission order, history and physical, individualized plan of care, interdisciplinary team meetings, IRF patient assessment instrument (PAI). HMI Performs a Review of Medical Records for Inpatient Rehabilitation Facility (IRF) in Nashville.

Review of Medical Records for Inpatient Rehabilitation Facility (IRF)

Our consultant specialists will perform a comprehensive review of the patient medical record to ensure all charges are captured appropriately, reimbursement is optimal for the services provided, and a schedule exists for filing the minimum data set (MDS) and claims in a timely manner. HMI Performs Medical Records Review for Skilled Nursing Facility (SNF) in Nashville.

Skilled Nursing Facility (SNF) Medical Records Review for Reimbursement

Our consultant specialists will perform a comprehensive review of the hospice documentation to validate the billed HCPCS code for service location, HCPCS codes for visit disciplines (SN, CNS, SW, etc.), units, diagnoses codes, and billable supplies. A thorough review of the medical record documentation against the hospital final billed claim will confirm reporting accuracy. The key documents such as the certification of terminal illness, plan of care, and Interdisciplinary group (IDG/IDT) meetings are reviewed for completeness and accuracy in accordance with the episode of care. HMI is leading Hospice Revenue Cycle Management Companies and Coding Services.

Hospice Revenue Cycle Management | Claim Review, Coding Nashville TN

Our consultant specialists will perform a comprehensive review of the home health documentation to validate the billed HIPPS code, HCPCS codes for visit disciplines (SN, PT, OT, SW, etc.), units, diagnoses codes, and billable supplies. A thorough review of the medical record documentation against the hospital final billed claim will confirm reporting accuracy. The key documents such as the OASIS, plan of care, and face-to-face certification are reviewed for completeness and accuracy in accordance with the episode of care. HMI is leading Home Health Revenue Cycle Management Companies, HHA Claim Review , Home Health Agency Revenue Cycle and Coding Servicing Companies.

Home Health Revenue Cycle Management | HHA Claims Review | Coding

Our consultant specialists will validate the billed HCPCS codes, origin and destination modifiers, provider arrangement modifiers (if applicable), loaded mileage, and verify the diagnoses codes reported to Medicare against the patient trip record.

Ground Ambulance Claims Review Services for Reimbursement

Our consultant specialists will validate Ambulatory Surgery Center (ASC) claim review & Audit for the CPT©/HCPCS and ICD-9-CM/ICD-10-CM diagnosis coding and modifier (if applicable) assignment of surgical services and drugs used during procedures performed at ASCs. The medical record documentation is reviewed against the ASC final billed claim to confirm reporting accuracy. The claim review will include an assessment of documentation quality for supporting medical necessity. HMI is leading Ambulatory Surgery Center Revenue Cycle Management Companies and ASC Coding Services and Ambulatory Surgery Center (ASC) Claims Review Companies.

Ambulatory Surgery Center Revenue Cycle Management | ASC Claims Review | Coding Nashville TN

Objective: To provide a helpline resource for the provider community to address coding and billing questions that may arise during day-to-day operations. HMI will answer questions using the most current coding guidelines and published CMS billing guidance.

Resource: Our consultant specialists will be available to answer questions via an e-mail service related, but not limited to the following:

• Chargemaster
• CPT©/HCPCS/UB revenue codes
• Modifier application
• OPPS billing
• CCI /MUE / Device and Procedure Edits
• Medical necessity
• Physician E/M billing

The current guidance utilized by HMI to respond to questions will be communicated via e-mail. This allows the individual to have access to these resources for future reference on related issues.

Warranty: Every effort will be made to respond to questions within a to 72 hour period and ensure the accuracy of the helpline responses. HMI’s helpline responses will be supported by the most current CMS guidelines available. HMI’s interpretation of the CMS guidelines may not always agree with the Client’s local MAC. When HMI has direct access to the MAC Part A or Part B guidelines, we will provide the most straightforward response available.

It is the client’s sole discretion to apply current guidelines to its coding and billing practices based on the information provided. HMI Provides Helpline Services for Medical Billing and Coding Online.