Coding quality for large-sized home health service provider reached >98%
The Client
Large-sized home health service provider based out in the US
The Challenges
- Missed revenue opportunities
- Coding and billing integration
- Certified and experienced coders
- Payer specific nuances
Plutus Health Plan
Plutus Health’s dedicated team of coding managers, quality experts, and certified coders thoroughly analyzed the coding process of the client and detected the following issues:
Issues Detected
- Missed calibration between Oasis and Medical record
- Incorrect sequence results in HIPPS reimbursement
- Inappropriate resumption of care information
- Non compliance
After detecting the coding issues, Plutus Health’s coding experts create a personalized plan to provide an end-to-end coding solution.
Our coding experts helped the client review H&P (History and Physical), doctor’s note, medications, and assessment to determine the correct diagnosis codes.
Plutus Health Solutions
- Plutus Health’s certified coders (OASIS, AAPC, RHIA, HCS-D) identify hidden trends in lost revenue, clean claim rate, lost-revenue performance, and revenue performance to get maximum reimbursement.
- Plutus Health’s experts helped the client with regulatory requirements like OASIS-E, PGDM, and ICD-10 codes.
- Our specialists helped the client with all the complaint-related issues by conducting timely compliance audits and working on the audit findings.
- Plutus Health’s professionals helped the client accelerate reimbursement, reduce costs, and improve accuracy.
Results
- Improved Revenue
- The coding quality of the client improved.
- Fully compliant coding process
- Coding denials minimized
Achievements
- Coding quality for the client reach >98%
- Coding denials for the client reached <2%
- $ 200 improved per episode per patient
- OASIS responses in line with MR