Revenue Cycle Coding and Clinical Documentation Strategy

CLA can help assess your organization’s coding and clinical documentation accuracy and help operational leaders meet key coding and billing compliance education and training needs.

What’s on your mind?

• Remaining compliant with new coding and billing regulations
• Avoiding coding delays, inaccurate coding, and incomplete clinical documentation
• Improving outcomes related to performance indicators
• Integrating CMS documentation guidelines into daily decision-making
• Validating case mix indexes to reflect the types and severity of patients treated
• Managing increased cost of denials
• Preventing revenue loss due to invalid or inactivated procedure codes
• Recruiting experienced coders to fill staffing vacancies
• Modifying daily coding operations to provide cross-coverage of staff and ongoing education

Create opportunities with CLA

Successful health information management depends on accurate coding and clinical documentation, strong internal controls, and an information infrastructure able to support both. Our professionals have extensive knowledge of leading DRG and encoding software applications and usage, such as Optum 360 and Intelicode. We help you review patient and coding information, assess the completeness and adequacy of current documentation, and review documentation processes to identify new opportunities and potentially increase revenue. Based upon results from our coding quality assessment, we then offer customized educational training.

Coding education annual subscription

Strengthen your organization’s compliance and reimbursement skills with training and education for inpatient and outpatient coders, billing staff, and physician providers. CLA’s annual subscription for coding and clinical documentation education includes:

• Web-based educational sessions to review yearly changes and updates to DRGs, ICD-10, CPT/HCPCS, and Evaluation & Management coding and billing guidelines (four hours annually; eligible for CEU)
• Customized, web-based training on billing, coding, and clinical documentation to address topics such as Medicare Part A and B, modifiers, incident to rules, surgical packaging, telehealth, chronic care management, behavioral health integration, preventative care, and nursing visits (eight hours annually; eligible for CEU)
• Telephone inquiries regarding billing, coding, and clinical documentation compliance (up to 2 hours per month)

Revenue cycle coding and clinical documentation services

• Assessment of coding, clinical documentation integrity, associated claims, and identification of potential operational improvement areas
• Customized education and training for providers, nursing staff, and coding and billing resources related to clinical documentation of services, coding application, and missed revenue opportunities
• Compliance reviews to help validate findings and recommend next steps
• Annual ICD-10-CM and PCS, CPT/HCPCS, and E/M coding updates
• Coding quality reviews to include those under attorney-client privilege and assistance with payer paybacks or defense reviews
• Prospective and retrospective coding assessment and rebill opportunities

Learn more about CLA’s annual coding education subscription.