SolvEdge, enables hospitals and independent practices across all sizes and specialties to solve their most complex challenges. We synergize our vast experience to deliver the best outcomes for our clients. In this blog we share our most recent win!
Location: Illinois Hospital Type: Trauma Center Number of admissions: 100000
Conflicting priorities and regulatory pressures resulted in lost revenue due to a high rate of coding errors and CDI complexities. Their declining reimbursement and deficiencies in documentation were a major concern.
Trauma care centers struggle with enormous volumes of patient data as it isn’t unusual for a single patient to go through multiple procedures and varying diagnosis. In most instances, patients go through 20+ procedures prior to admission.
Identifying reportable data from extensive trauma records is challenging. Coding for trauma care centers requires not only a strong understanding of surgical procedure codes but also Evaluation and Management (E/M) codes.
The hospital was trying to improve the accuracy and continuity of its medical coding and CDI efforts. They understood that deficient documentation and medical coding could be a dangerous weak link. The Level 2 trauma care center wanted to set a foundation for improving compliance.
Our data-led approach standardized and quickened clinical documentation and coding workflows.
Our trauma-specific coding assessment bubbled up several inconsistencies. We identified that the trauma center focused its reimbursement efforts on DRG payments alone. This led to missed revenue opportunities. Revenue codes were routinely missed for patients in intensive care settings.
We automated code capture for commonly used revenue codes and created a streamlined coding process. With a strong focus on performance outcomes we ensured gains in efficiency and coding productivity within three months of engagement. Stringent quality metrics, integrated workflows, and accurate pre-coding maximized revenue capture for the hospital.
Increased coding productivity and eliminated backlog
98% coding accuracy
24% increase in RVUs
0% post-coding rework
93% reduction in DNFC
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