Expert Clinical Coding Audits for Improved Results

Client Profile:

A leading U.S. healthcare organization with acute care hospitals and outpatient clinics with a diversified portfolio of over 20 affiliated hospitals in rural and mid- sized markets across more than a dozen states with an aggregate of 1,800+ licensed beds.

Challenge:

The healthcare organization’s internal audit team had been dissolved. The Corporate Compliance Director reached out to AQuity to assist with the annual coding audits needed to comply with the Office of Inspector General’s billing audit requirement.

Approach:

AQuity Audit Leadership worked with the compliance department to identify the case types needing to be audited and then matched AQuity auditor’s skill sets for each case type. AQuity used a team approach with a backup auditor for continued coverage if the primary auditor was out.

Results:

The AQuity Clinical Coding Audit achieved:

  • Identified missed secondary diagnoses and chronic conditions for cases in both inpatient and outpatient settings
  • Improved justifiable reimbursement and mortality indexing
  • Gradual decreased errors produced by the in-house coding team from the first six months to last six months of auditing through ongoing education
  • Program expansion to physician groups due to initial hospital-based audit success
  • AQuity Coding Director added to the client’s Corporate Compliance Committee as an outside subject matter expert representative

To learn more about AQuity Solutions coding audit and support services, contact us today at info@aquitysolutions.com.

CATEGORY

Medical Coding Audits

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