Clinical Documentation and Coding Integrity

Health Solutions

September 17, 2015

Health system professionals know that appropriate provider documentation and accurate coding do not necessarily go hand-in- hand. Complete and compliant code submission is integral to organizational success. Healthcare revenue integrity and quality reporting require a team approach. Given the increasing complexity in ICD-10-CM and PCS coding and related multiple Diagnosis Related Group (DRG) methodologies, applications of “Present-on-Admission” indicators to assess hospital outcomes, the growth of Recovery Audit Contractor (RAC) entities, and the rise of reimbursement based on bundled payment, and risk adjustment methodologies tied to Hierarchical Condition Categories (HCC), it is critically important that hospitals and other healthcare provider organizations address clinical definition, documentation and coding issues. FTI Consulting’s CDCI™ clinical and coding staff works with your physicians, nurses and coding professionals to accurately represent the nature of your patients’ illnesses, the quality of your services and the integrity of your coding and billing process.

FTI Consulting provides proven solutions that support compliant reimbursement while maintaining enterprise revenue integrity. Our comprehensive advisory services and tools invest your medical, clinical and coding professionals in compliant, accurate processes. While compliantly adhering to ICD-10 and other billing requirements, the FTI Consulting experienced Clinical and Coding advisors will:

  • Deliver a flexible solution tailored to your unique situation
  • Utilize comprehensive and flexible tools and templates to systematically document clinical activity
  • Provide payors with complete, accurate data using correct codes, modifiers, and supporting information
  • Support a rapid and smooth implementation while minimizing overall costs and helping maintain or improve profitability
  • Provide operational tools to help manage daily requirements and monitor progress

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