MB-4574 - USA (Texas) - Compliance Billing and Coding Audit Services - Deadline October 27,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4574

Government Authority located in Texas; USA based organization looking for expert vendor for compliance billing and coding audit services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

Vendor needs to provide compliance billing and coding audit services to Medical Documentation, Billing, and Coding Compliance specialists certified through the American Health Information Management Association (AHIMA) or American Association of Professional Coders (AAPC). Accepted credentials include RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician), CCS (Certified Coding Specialist), CPC (Certified Professional Coder), and Certified Risk Adjustment Coder (CRC).
- Compliance Billing and Coding Audit specialists to have no less than five (5) years of experience in providing Medical Documentation, Billing, and Coding Compliance review services.
- Proposer will also advise on best practices with respect to prospective and retrospective compliance billing and coding audits. Proposer will also evaluate accuracy on a coder specific basis and identify any areas for educational improvement. Proposer will identify provider documentation improvement opportunities on a provider specific basis and identify any areas for educational improvement.
- Outpatient encounters for assessment and review will be selected by UT Health San Antonio’s Compliance Department. The encounters selected will be based on UT Health San Antonio’s risk assessment data, including volume, dollars, and other risk-based criteria.
- The objective of the above is to determine the accuracy of code assignments and the identification of any variations which may have an impact on the organization’s reimbursement when compared against existing clinical documentation. Proposer will work with the Compliance Department to identify areas for improvement and targeted or general educational opportunities for providers as a result of provider specific audit findings.
- Development of a standard report template that will be used to deliver the results of the coding assessment;
- Development of a standard worksheet that will be used to collect the individual results of each admission/encounter;
- Development of a process to communicate the status of the review work on a periodic basis (e.g. once every two weeks) and to escalate any instances of high error findings;
- Development of a project management plan & process including timetable.
- For more information describe in document.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

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

Expiry Date : Tuesday, 27 October, 2020

Category : Medical Billing and Coding

Country : USA

State : Texas

Cost to Download This RFP Document : $ 5

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