We specialize in Coding
Coding Accuracy
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HCC
Emergency
Radiology
E&M
Hospital
Pharmacy
HCC = Hierarchical Condition Category. We specialize in HCC!
Medcodia has put in place an expert team of highly credentialed and experienced coders. All our coders are AAPC certified, have a minimum of 5 years of experience and continually working to stay on top of latest changes in the industry.
Commercial / HIX =
Even though Medicare Risk Adjustment (MRA) is where Risk Adjustment Model started but Commercial insurance companies have adopted Risk Adjustment Model with a little variance.
There are some diagnosis part of MRA Risk Adjustment but not included in HHS Model and vice versa. It is very important to know the difference to code with accuracy. At Medcodia, we have certified trained coders with minimum 5 years of experience with in both coding models to avoid errors or missed any coding opportunities that could result in loss of revenue.
medcodia RADV Process
RADV = Risk Adjustment Data Validation Audit: CMS process that ensures the integrity and accuracy of the providers data submission to substantiate risk adjustment. The goal of the RADV Audit is to identify any discrepancies by comparing risk adjustment diagnosis data submitted by a Medicare Advantage (MA) organization via encounters and claims, against the data provided to CMS per the RADV audit process.
• We will provide you a dedicated team of expert coders and auditors just for your project.
• You will have a direct phone line provided to reach your team’s lead and address any of your concerns directly and promptly.
• Medcodia will instantly reduce your overhead cost. Immediately save you between-30 to 40 % of your initial cost of vendor service and will provide you highly trained and experienced certified coders to complete any size project with high efficiency and accuracy.
• Coders will abstract & audit charts to increase your ROI on any of missed revenue.
• All reports will be customized per client’s needs. We will provide Charts Retnevol Status, Charts.Codecl status, Charts Audited Status, Actual Inventory at Charts and any additional intormation client needs. Our coders keep 95% to 98% accuracy of work. We are successful by making our client’s needs and goals aligned as our goals.
Suspected Diagnosis Coding
Medcodia works with Healthcare providers to identify suspected diagnosis by reviewing the following:
• Physician Progress Notes
• Hospital Notes
• Labs
• Radiology Reports
• Pathology Reports
By proactively identifying suspected diagnosis, which in turn helps physician with their patient’s medical possible conditions. This helps improve patient level of care with all the possible diagnosis.
Medicare Part C and Part D
Medicare reimburse Insurance companies for their patients under Medicare Advantage Plan for their Part C and Part D reimbursement using HCC Risk Adjustment Model.
At Medcodia, our coders know the importance of each diagnosis attached to HCC Risk Adjustment and how it can have clinical as well as financial impact. At the same time, our coders also understand any wrong diagnosis submission will have negative impact clinically as well as financially.
Our coders use Outpatient (OP) & Inpatient (IP) coding guidelines for proper code assignments which also includes supporting documentation of codes recorded by physician using MEAT.
We provide detailed information of diagnosis that can’t be captured due to insufficient documentation by physicians.
At Medcodia, we know the importance of impact of these diagnoses and have prepared to take on any sizable project. Our Certified Coders have over 5 years of HCC MRA Risk Adjustment Coding experience and will be exclusively assigned to work on your project.
At Medcodia, we have coders experience in
• Part C (HCC) and Part D (Rx HCC) – Unique ICD once per year
• Part C (HCC) and Part D (Rx HCC) – Unique ICD twice per year
• Part C (HCC) only – Unique ICD once per year
• Part C (HCC) only – Unique ICD twice per year
• Part C (HCC) only – All Encounters
Part C (HCC) and Part D (Rx HCC) – All Encounters
Complete Code Capture
Complete Code Capture, aka: Full Code Capture in which coders code every single confirmed diagnosis based on coding guidelines. For complete code capture, medcodia experience coders abstract all confirmed diagnosis on every encounter as per outpatient/inpatient coding guidelines.
Radiology Coding
Radiology is integral to the health care system!
Medcodia specializes in coding for diagnostic and interventional radiology services.
“Our relationship with client begins by understanding their unique challenges and needs, by aligning our goals with yours.”Radiology Coding:
Diagnostic Radiology
Medcodia specializes in coding for diagnostic services
Medcodia will assist providers of radiology services to overcome the complexities of radiology coding, documentation and reimbursement. Our goal is to ensure that providers are correctly documenting all services and accurately coding for those services to ensure optimal reimbursement while maintaining compliance with all coding and regulatory guidelines.
Whether you are an independent diagnostic testing facility, hospital, radiology practice or billing company we can assist you with the following:
Eliminate Radiology Coding Backlogs
Complete Outsourcing & Backlog Coding Support – Diagnostic and Interventional Radiology
We can assist in long-term or short-term coding. We love to code!!
Interventional Radiology
Medcodia specializes in coding for INTERVENTIONAL SERVICES:
Medcodia will assist providers of radiology services to overcome the complexities of radiology coding, documentation and reimbursement. Our goal is to ensure that providers are correctly documenting all services and accurately coding for those services to ensure optimal reimbursement while maintaining compliance with all coding and regulatory guidelines.
Whether you are an independent diagnostic testing facility, hospital, radiology practice or billing company we can assist you with the following:
Eliminate Radiology Coding Backlogs
Complete Outsourcing & Backlog Coding Support – Diagnostic and Interventional Radiology
We can assist in long-term or short-term coding. We love to code!!