Correctly
documenting all elements of patient care, utilizing payor appropriate
nomenclature and subsequent coding of that documentation is essential for
regulatory compliance and appropriate payment for the intensity of services
provided. Often, complete coding sufficient for appropriate and compliant
reimbursement can be hampered by hospital staffing challenges.
| How often
do you see this? |
|
When it should have looked like this? |
| DRG 89 Simple Pneumonia/Case Wt. = 1.0320 |
|
DRG 79 Resp Inf. & Inflammations/Case Wt. = 1.6238 |
| Length of Stay = 6 Days |
|
Length of Stay = 6 Days |
| Charges = $25,000 |
|
Charges = $25,000 |
| Cost = $8,000 |
|
Cost = $8,000 |
| Reimbursement = $5,676 |
|
Reimbursement = $8,931 |
| Negative Contribution Margin = ($2,324) |
|
Positive Contribution Margin = $931 |
| Negative LOS Delta from GMLOS = (-1.3 Days) |
|
Positive LOS Delta from GMLOS = 0.7 Days |
| |
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MD-X provides hospitals with the necessary tools and expertise to enable
meaningful and lasting documentation and coding changes. The MD-X team of
qualified professionals includes:
Physicians
- MD-X physicians have extensive experience in private practice, payor
relations and HIM coding that supports hospital initiatives through direct
peer-to-peer communication.
HIM Professionals
- MD-X HIM team members are certified senior professionals capable of assisting
hospital staff in both regulatory and process improvement.
Care/Case Managers
- MD-X care/case management professionals provide training and guidance to
hospital’s care/case managers and social workers. Team member
understanding of reimbursement and compliance implications of their work is
essential to their communication with each hospital’s medical staff.
To deliver lasting HIM coding changes, MD-X services include:
 Education of Physicians, HIM Coders and Case
Manager
Re engineering of the Coding
Process - to include daily interaction
Sophisticated technological
support tools
Ongoing support during the
transformation process
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