Wednesday, March 26, 2014

ACK - Complete Tool For Medical Reimbursement










 

AccuChecker
 

Up-to-Date Medical Coding Data at your Fingertips
 

ü  Corrective Coding Initiative - CCI

ü  ICD-9

ü  ICD-10 for 2014 (NOW Available)

ü  Simple, Easy to Use and Accurate. 

ü  Developed by Team of Medical Experts with 31 years experience.

ü  Faster Precise Coding Techniques for less than $1.00 a day

ü  Medical Necessity, Procedures and Matching Diagnoses

ü  Medicare Fee Schedules, and Local Coverage Determination

ü  RBRVS for Structuring Fee Schedules

ü  Inclusive/Exclusive Procedures to Detect Bundling

ü  Modifiers for correct coding

 

The Subscription also includes: 

Support Hotline – Unlimited EMAIL Support 

For more information or on pricing, please call 305-227-2383 or 1-877-938-9311 


 

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Tuesday, March 25, 2014

SEMINARS & CONSULTING SERVICES





SEMINARS & CONSULTING SERVICES
CLAIMS ADJUDICATION
Tired of costly errors? Develop your claims scrubber


 

A claims scrubber module represents the most basic cost containment tool for payers and TPAs in adjudicating claims and for IPA and MSO analyzing claims paid by the HMOs if risk agreements contracts are in place. Millions of dollars can be saved! 

A claims scrubber with pricing (fees) capabilities can simplify the job of case managers estimating claims of services rendered by providers that are not participating in the insurance company panel and are considered “out-of-network”
 

Our HPP AccuChecker team has developed seven (7) claims scrubbers systems in the last fifteen years – we learned that a team of programmers and healthcare reimbursement experts working together can develop their own claims scrubber in 60 to 90 days. It is understood that adequate training and a good map of the adjudication rules will guarantee the success of the in-house scrubber.
 

A good in-house claims scrubber must: 

·         Adhere to CMS and AMA adjudication guidelines in paying claims

·         Verify members participation in the insurance plan

·         Validate dates, places of service, procedures, modifiers, units, pricing, diagnosis (ICD-9-CM and ICD-10-CM) codes and co-payments

·         Adjust duplicate lines in claims

·         Keep an eye on UPCODING and the relationship between E & M procedures and places of service

·         Reject double billing when global fees and modifier 26 are charged simultaneously for the same day of service – common in hospital radiology services

·         Check medical necessity by matching procedures and diagnoses

·         Identify and react to UNBUNDLING by using up-to-date CCI tables

·         Track payment of bilateral and multiple procedures including endoscopy services

·         Follow basic rules on claims using numeric and alphanumeric modifiers for surgical, medical, diagnostic and rehabilitative services

·         On inpatient admissions observe that there is only one admitting physician and that double charges for ER and admission are flagged

·         In the case of Medicare and Medicaid HMOs stay in constant watch on the two major areas of waste and mismanagement by some of the Plans – Pharmacy and Behavioral Services

·         A more advance analyzer will take care of HEDIS and PQRS measures – Alerting by patients in file the measures required by member during the year and the status of measures pending for each participant during the pertinent filing period.

 

FOR MORE INFORMATION ABOUT
CLAIMS ADJUDICATIONS
SEMINARS & CONSULTING SERVICES
Please contact us at (305) 227-2383

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AccuChecker - CODING MADE EASIER FOR LESS


CODING MADE EASIER FOR LESS

AccuChecker OnLine

Since 2000 Physicians, Billers, Case Managers, Payers & MSO/IPAs use it!

AccuChecker OnLine is an Internet database subscription service with procedures, diagnoses (ICD-9-CM and ICD-10-CM), Medicare fee schedules using RBRVS tables and coding techniques   

AccuChecker OnLine is updated periodically. 

AccuChecker Online is used by physicians and their office staff, billing services, case managers and medical schools, HMOs, MSOs, IPAs, Third Party Administrators (TPAs) and payers. 
 

 
FREE SERVICES TO ALL AccuChecker OnLine USERS
 
Our users enjoy two (2) FREE services: HOTLINE Support and the AccuLibrary:
 
·         HOTLINE Support – subscribers can send emails to our consulting staff with questions about reimbursement, coding and compliance
·         AccuLibrary – an excellent reference source of information about important topics in practice management and reimbursement
 

 
AccuChecker OnLine BASIC

The AccuChecker OnLine BASIC is the ideal tool for the practice that demands limited coding but that can take advantage of our comprehensive state-of-the art ICD-10-CM system and FREE-HOTLINE support. 

The AccuChecker OnLine BASIC cost less than 50 cents a day yielding the highest rate-on-investment (ROI) in healthcare today.  

The AccuChecker OnLine BASIC is an Internet service with:

·         Procedures  – CPT, Category II and HCPCS codes

·         Diagnoses codes (ICD-9-CM and ICD-10-CM)

·         Converter of ICD9 to ICD10 

 

Accuchecker OnLine CLASSIC


AccuChecker OnLine Classic has been the only AccuChecker OnLine version since 2000 hundreds users from across the nation use the CLASSIC and renew their subscriptions every year, we are most grateful for their support and loyalty.
 

The AccuChecker OnLine CLASSIC is designed for medical practices that require coding techniques and pricing services. Fast, accurate, easy-to-use Coding and Pricing Techniques for less than $1.00 a day
 

The AccuChecker OnLine CLASSIC is a comprehensive database with: 

·         Procedures  – CPT, Category II and HCPCS codes

·         Diagnoses codes (ICD-9-CM and ICD-10-CM)

·         Converter of ICD9 to ICD10

·         Medicare fee schedules including OPPS rates in radiology

·         Coding techniques like:

o   Corrective Coding Initiative (CCI),

o    Medical Necessity – procedures matching diagnoses,

o   Medicare’s LCD and NCD,

o   Surgical modifiers outlining coding guidelines

o   Global period for surgical services – 0, 10 or 180 days

o   Diagnostic procedures with modifiers - 26, TC and global. 

 

Our new two products including Pay-for-Performance tools: 

·         AccuChecker OnLine BASIC + P4P   

·         AccuChecker OnLine CLASSIC + P4P
 

P4P – The PAY-FOR-PERFORMANCE Alternative 

The HPP-AccuChecker Management Team is moving into the new frontier in healthcare reimbursement the Pay-for-Performance (P4P) alternative, the new way how healthcare providers receive their compensation, where HEDIS, PQRS and other reporting systems become intrinsic modules of our software reimbursement applications.

We are committed to keep our customer base ahead of the game and to assist our clients in maximizing the compensation that they deserve for their efforts. 

The BASIC + P4P  and CLASSIC + P4P are the ideal tools for medical practices with a Medicare population that participate in Medicare and/or Medicaid HMO Plans. 

Pay-for-Performance works  

·         We find that in practices participating in Pay-for-Performance activities, physicians and managing staff show excitement about reporting HEDIS and PQRS measures for two simple reasons they receive compensation from Medicare and Managed Care Plans for enforcing Pay-for-Performance measures and also for improving the quality of care of their patients. Consequently, such actions produce a dramatic impact in achieving cost containment. 

·         We have also witnessed that HMO plans with of 4.0 of higher STAR RATINGS are the ones compensating their PCPs handsomely and the PCPs reciprocate to the plans with vigor and enthusiasm. A win win alternative. 

 

For More details please call 305-227-2383 or 1-877-938-9311
 


 

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