Your Mission...Should you choose to accept it...
Unless you are involved in Hospital HIM, Coding or Business office this probably makes no difference to you.
But it should.
Why would the use or omission of this code be vital to the general population? Because it's our personal and private health information in our personal and private medical record that is being audited.
Audits and Payer denials will not decrease due to the inclusion of this code. If anything, it's appearance it may in fact up the audit denials anti. It is a trigger for exploration into the medical record to see that all expectations and criteria for the stay have been met.
Payer appeals is our forte', but we are consumers too. Consumers who can not afford to be hit with additional cost beyond our extreme out of pocket and skyrocketing healthcare premiums. We are advocates for proper payment by the insurers in the age of BIG DATA. At our disposal is a secure portal system in which we can streamline and tailor AR analytics, ROI reporting and offer more details about "Not Medically Necessary", or "Administratively Denied".
Medical records of patients with morbidities and conditions that require more frequent care in the hospital setting, and the Hospitals who serve them will be facing even more scrutiny. The medical record will be open and exposed creating a greater chance for vulnerability and recoup.
Premier Medical Appeals is here to help those Revenue Cycle Managers and CFOs who are ready to see the value of partnering with us and utilizing our expertise to Audit the Auditors and answer Payer denials.
Our mission which we have fully accepted is to help you stop up the leaking out of your justified Hospital Revenue and bolster your front and back end process, resulting in sustainability.
our Mission, should you choose to accept it, is to partner with us and regain control of your Denials and Appeals Process.