With the advent of recovery audit contractors (RAC) and a slew of other state and federal provider audits, lack of coding compliance can cause real financial challenges. Aviacode's coding services help eliminate coding inconsistencies that lead to non-compliance, and reduce the risk of revenue loss.
The risks of medical coding have gone up. With the costs of potential fines, sanctions, interest payments, no provider can afford to disregard coding compliance. But there's another side to the compliance coin, as greater compliance may also improve revenue. Just as inadequate compliance can leave you open not only to "over-coding," it can also make "under-coding" a real possibility. And that means you leave money on the table.
The bottom line? Without compliance, it will suffer.
Aviacode combines workflow and technology to increase compliance.
Aviacode is the only service provider to offer an in-line quality assurance (QA) review process. After coding is complete, a separate group of QA specialists score coding selections and find problems before you ever see them, so you experience 95% or better coding accuracy. In addition, our exclusive rules engine gives you added security.Take CARE™ of compliance with Aviacode's Coding Analyzer & Rules Engine.
We've enhanced 3M's Edit Engine to create the Coding Analyzer & Rules Engine (CARE™), a system that validates code selections across patient insurance, location and patient demographic information. The system verifies code selection and maintains a precise history of each policy change (including reasons, citations and dates) to help reduce claim denials, optimize reimbursement and achieve compliance. The system validated coding results against 6 million rules, including:- Current and historical CPT/HCPCS codes
- Current and historical ICD9 procedure codes
- Current and historical APC & DRG codes
- Current and historical ICD-9 diagnostic codes
- Correct Coding Initiative Guidelines (NCCI)
- Outpatient Clinical Edits (OCE)
- Medical Necessity Policies (NCD/LCD) for Medicare in all 50 States
- Client based rules engine for enforcing organizational coding policy
OLD COPY
Consistent Results. More Compliant.
Healthcare providers today must achieve higher levels of accuracy in their clinical documentation and coding or face possible financial penalties. Substantial financial consequences are a reality for physicians with poor coding practices. The bottom line is that physician practices must have effective coding compliance programs.Coding Analyzer & Rules Engine (CARE™)
Aviacode delivers coding compliance with internet technologies and an enhanced integration using the 3M Edit Engine. Our Coding Analyzer & Rules Engine (CARE™) system validates code selections across patient insurance, location and patient demographic information. The system verifies code selection and maintains a precise history of each policy change (including reasons, citations and dates) to help reduce claim denials, optimize reimbursement and achieve compliance. Coding results are validated against 6 million rules, including.- Current and historical CPT/HCPCS codes
- Current and historical ICD9 procedure codes
- Current and historical APC & DRG codes
- Current and historical ICD-9 diagnostic codes
- Correct Coding Initiative Guidelines (NCCI)
- Outpatient Clinical Edits (OCE)
- Medical Necessity Policies (NCD/LCD) for Medicare in all 50 States
- Client based rules engine for enforcing organizational coding policy