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MB-3456 - USA (Texas) - Inpatient and Outpatient Documentation or Charge Review Professional Billing Documentation and Coding Services - Deadline October 14,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3456

Government authority located in Texas, USA; based organization looking for expert vendor for inpatient and outpatient documentation or charge review professional billing documentation and coding services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

Vendor needs to provide inpatient and outpatient documentation or charge review professional billing documentation and coding services.
- improved focus on quality and documentation compliance via data analysis and reporting
- Assist in development of a more robust and coherent medical record to support quality of patient care
- Improve communication among and with physicians regarding documentation needs and expectations
- Target missed documentation opportunities
- Develop a process to maximize risk of mortality and severity of illness as well as CC/MCC capture rates
- Reduce unspecified diagnoses
- Ensure appropriate principle diagnosis assignment
- Increase appropriate DRG assignment
- Maximize case mix index
- Improve mortality ranking
- Ensure appropriate present on admission assignment
- Improve net revenue opportunities
- Conduct an Outpatient Coding Audit
- Develop and integrate an approach, process and infrastructure for a proactive Program to address root cause opportunities, educate, review and provide continuous feedback and measurement on progress and results.
- Conduct education with the clinical departments and admitting providers based on chart reviews and claim review findings to address key areas of opportunity.
- Conduct education with Physician Advisor, UR leadership, UR staff and attending physicians regarding appropriate patient status assignment and documentation to support medical necessity.
- Reduce status changes through additional education and improved documentation by the treatment team.
- Conduct a staffing analysis of UR and recommend staffing levels needed to take the UR staff to the next level of performance
- Provide clinician education and/or educational resources for invested improvement when deficiencies are identified.
- Provide clinician education and/or educational resources for clinicians and/or billing staff for improvement when deficiencies are identified
- Ensure proper teaching physician attestations to residents’ notes in both inpatient and outpatient settings.
- Ensure brief operative- notes, and/or operative notes are complete, and contains the elements necessary to describe the procedure(s) performed, including medical necessity, capturing of any unusual circumstances
- Evaluate physician documentation for proper representation of Assistant at Surgery vs Co-Surgery vs Team Surgery; and make recommendation of what is needed to reflect as such in the documentation.
- Potential for providing specialized training services for both surgical and non-surgical coders/billing staff.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Monday, 14 October, 2019

Category : Medical Billing and Coding

Country : USA

State : Texas

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