Coding for healthcare services is an increasingly complex discipline requiring ongoing attention and understanding of regulatory changes, patient care and clinical documentation.
Coding requires highly-skilled staff in a competitive labor market. Healthcare providers are forced to acquire technology and leverage other costly alternatives such as temporary workers to fill gaps. Some of these temporary solutions do not result in quality work, thus impacting the integrity of the entire revenue cycle, and ultimately financial outcomes.
R1 Coding Management Solutions offers a differentiated approach to coding capabilities with demonstrated results. Through a combination of services, education, quality measurement, and analytics-driven continuous improvement, R1 offers an effective partnership to support your strategic revenue cycle goals.
Insight into performance is the cornerstone of achieving high quality and accuracy in coding. Daily DNFB and weekly individual productivity scorecards enable transparency into processes and team member effectiveness.
Comprehensive screening and onboarding of candidates paired with thorough training and continuing education provides the foundation of an effective coding organization. Data-driven performance management and quality assurance ensure ongoing consistency in term member results.
A governance structure leveraging defect-oriented analytics, standard tolerance thresholds, and account ownership drives quick containment of issues and ensures DNFB stays on track.
A four-stage quality and compliance program including pre-bill auditing, review by certified auditors, corporate compliance review in high risk areas, and external audits (as deemed necessary) minimize risk related to coding and billing accuracy.
In addition to finding and uncovering net revenue for our organization, R1 works closely with our clinical and corporate teams to educate and correct billing and coding practices on the front end to mitigate downstream issues.
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