ICD-10 Auditing Services
We understand how imperative it is for hospitals and health systems to maintain accurate code assignments to optimize reimbursements that accurately reflect quality services and minimize regulatory and compliance liabilities. ECLAT Health Solutions provides comprehensive auditing services to support hospitals and health systems focused on inpatient, outpatient, and pro-fee coding for ICD-10-CM/PCS, CPT-4 and HCPCS code sets.
Ongoing quality audits help our clients better understand the return on investment (ROI) and accuracy of each individual coder on their team as well as their investment in external contract coding resources. In addition to monitoring and improving the accuracy of coders, ECLAT identifies clinical documentation improvement (CDI) opportunities to make sure physicians are providing accurate and complete documentation resulting in decreased queries, and accurate and specified code assignment.
Customizable Frequency & Sample Size
The frequency of audits can be tailored to meet the specific needs of each individual hospital or health system. Services can be availed per clients’ needs bi-annually, quarterly, or other desired parameters depending on the interest and goals. Support can be provided on all chart types, specific chart types, specific coders, high alert cases (RAC, OIG, etc.), or other focused areas (MS-DRG, ROM, SOI, APR-DRG, APC, POA, etc.). ECLAT can accommodate your preferred sample sizes or provide the recommended sample sizes for different charts types and/or code sets to be audited.
Specialties & Expertise
ECLAT provides expert auditing services focused on the following areas. Customer has the option to pick and choose individually from ECLAT’s many services:
ECLAT follows official coding guidelines and references (such as Coding Clinics, CPT Assistant, NCCI, NCD/LCD, OCE and MCE), in addition to Customer-specific guidelines to the extent such guidelines do not contradict official resources. Payer-specific requirements are also taken into consideration.
Additional Focus Options
ECLAT can provide your practice with the following focus options, if requested:
Also, wherever noted and/or requested, ECLAT will document discrepancies with the following:
Audit Findings & Education
Education and training is a critically important part of any audit. Education and training are available to the following team members upon request: CEO, CFO, Controller, HIM Director, Coding Manager, Coding Supervisors, Coders, and Physicians.