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HMI | Physician Servies for Medical Claims

Physician Services

HMI Specialists provide review of Physician E/M coding and billing, super bills, documentation requirements, and policies and procedures. Provider education regarding billing, coding and documentation is provided.

Physician Services

Physician Services

Physician/Provider Claims ReviewOur consultant specialists will validate the billed E/M visit code against the documented encounter note in accordance with current CMS Evaluation and Management Documentation Guidelines. The review will ensure the physician or mid-level provider (NP, PA) has adequately documented the required elements for the key components intended to support the E/M visit code reported. Where applicable, CMS Teaching Physician documentation guidelines are applied to the review.

Physician Office ServicesOur consultant specialists will review office and inpatient E/M visits coded and billed, office superbill, office staff policy and procedures, and provide education for physicians/providers (MD, NP, PA) and staff. This review confirm coding and billing compliance with CMS rules and regulations, most current ICD-9-CM/ICD-10-CM diagnosis and CPT© codes are used on office superbill, and staff is performing duties in accordance with office policies and procedures. One-on-one education will be provided to all physicians/providers and if applicable may include designated office staff education.

Charge Capture – Physician ServicesOur coding specialist will review the medical record for appropriate diagnoses assignment and capture E/M levels and/or procedures for billing.