Why professional fee medical coding, auditing and compliance is even more important in a value based reimbursement world than a FFS world!
Brian C Smith
Lead Independent Director at Medliminal and Care Heroes, Consultant to Remote Care Partners-the national leader in Remote Patient Monitoring-Open for new private or public board opportunities
CMS and Managed Care Organizations of all flavors are rapidly moving reimbursement to various forms of risk based incentive models. Ok everyone knows that.
But what is THE most critical root cause of demonstrating quality improvements through HEDIS, STARS or any pay-for-performance model in existence or to be developed?
Provider documentation and precisely coded medical coding- both CPT and ICD-10. With rampant medical coding errors ( audit data shows up to 30% error rates) , providers trying to move the needle on quality improvement will fail unless they address this "dirty little secret".
The ONLY way to execute on a strategy to eliminate these errors is to get serious about implementing a rigorous compliance and audit management program. Luckily there are now cloud based tools available that can help you solve for this difficult equation.
If you want to get serious about preparing for this new era of value based reimbursement and position your practice or hospital to win, reach out to me at [email protected] or 626-298-3178