Outpatient (OPPS) Revenue Cycle Maintenance Program - old

The program includes analysis of Client’s outpatient/ancillary services and clinic services impacted by CMS OPPS: review of entire CDM for outpatient/ancillary (including clinics) line items for accuracy of the CPT/HCPCS, UB revenue code, and modifier assignment for compliance with federal and fiscal intermediary rules and regulations, price comparison vs. allowable reimbursement levels, and review descriptions for meeting Client’s internal standards. Additionally, our consultant specialists perform reviews of outpatient medical records and billing documents to ensure coding (ICD-9-CM, CPT, HCPCS) compliance with current guidelines and optimal reimbursement from all payors.

The scope of the engagement may include monthly, bi-monthly, or quarterly on-site services with our consultant specialist who will provide technical expertise to include:

Comprehensive outpatient chargemaster departmental reviews
Charge screens/order entry reviews corresponding to CDM maintenance
Reviews and updates for department charging tools
Bill audits for outpatient services
Medical record reviews for outpatient services
Continuing education for hospital staff
Implementation and quantification of recommendations
Added Feature:

Coding and Billing Helpline provided at no additional cost during the term of the contract. Client’s staff may take advantage of this helpful service to communicate directly with their on-site consultant specialist when billing and coding questions arise from daily operations.

Rodney Adams

MMCH, Associate Administrator of Finance Williamson Medical Center

“I have had the privilege of working with HMI over the past 10+ years with two different health systems. I have used HMI for hospital CDM and compliance reviews as well as physician coding reviews and education. I always receive top-notch service from the HMI team and I appreciate working with a partner that is always honest and responsive to my questions and needs. I have worked with Mary Quimby and Vickie Faler and both have proven to be very knowledgeable, accessible, and professional.”

MaryAnn Hastings

CPMA, Director Revenue Cycle Operations, Galen Medical Group

Having worked in healthcare revenue cycle for more than three decades, I have partnered with many vendors. My vendor of choice for CDM Review, E/M Coding Compliance and Physician Education is without a doubt HMI, LLC. Mary Quimby and Vickie Faler are not only subject matter experts, they are true partners providing that extra level of service that sets them far above others in the industry. I have worked with them for 15+ years in 5 different acute facilities, and multi-specialty physician groups. Using their sophisticated, data driven modeling, they have identified significant revenue opportunities for all my facilities using overall conditions, code level conditions, comparison conditions, relationship conditions and category constraints as part of their approach to the CDM review. I highly recommend them for their expertise and commitment. You will find none better.

Jessica Mayfield

Manager Revenue Management University of Missouri Health Care

We have utilized HMI’s for chargemaster compliance and billing reviews for nearly 10-years. We have always found that their staff to be knowledgeable, resourceful and professional in all services provided to our organization.

Dawn Chrismer

RHIT, CHC, CCS-P Director of Business Services/Compliance Officer Heritage Medical Associates, Nashville, TN

We recently transitioned to HMI from another Physician Documentation & Coding Compliance Review vendor, and the entire experience has been positive. HMI has been extremely accommodating throughout the process and has demonstrated a willingness to adapt to our workflows, leading to a seamless transition. We’ve received positive feedback from our providers about their experiences with HMI, and the Coding Hotline has been an invaluable resource. For anyone looking for a new consulting partner, I would highly recommend HMI.

Janet Willis

Director of Revenue Management, Monadnock Community Hospital

We have been working with HMI since 2010 and have expanded the use of their services to include CDM and ED Coding. The HMI coding staff is extremely knowledgeable and has become an integral part of our coding team. Our consultant Beth never shies away from any CDM project that comes her way. We appreciate the professionalism and teamwork we have with HMI.

Greg Yost

PFS Director Princeton Community Hospital, Princeton WV

"I have had the privilege of working with HMI for twenty plus years and have always found their representatives to be professional and knowledgeable in all aspects of acute hospital and professional service charge master management. Additionally ongoing coding related reviews and billing reviews and associated report backs are timely and positively impact appropriate revenue capture - billing - and compliance." "I recommend HMI to be considered when choosing a partner to assist with the complications of maintaining an accurate charge master and associated billing and coding practices."

David Alley

CFO Athens Regional Medical Center, Athens TN

We have utilized HMI Corp. since 2002 for consultation services related to chargemaster review and updates and have always found their services to be professional of nature and valuable to our organization.

Purvi Jani

AVP Reporting and Revenue Cycle MedStar Washington Hospital Center

HMI has been a great partner with MedStar Washington Hospital Center now for many years. We can always count on them to provide us with support on small to very large projects. HMI delivers consistent and honest results and additionally provides very thoughtful & targeted education to our physicians.

Denise Moore

CCS Coding Manager Princeton Community Hospital

HMI has been a very reliable resource for Princeton Community Hospital for many, many years. I have had the opportunity to work with many staff members and have found all to be reliable and courteous in every aspect. The staff is very flexible and provides Princeton Community with the support and coding stability needed. Thank you for the sometime short notices for coding coverage when unexpected situations arise with our staff. We thank you for your coding expertise as well as your continued auditing support and look forward to a lasting relationship for future endeavors Denise Moore, CCS Coding Manager Princeton Community Hospital

Robert C. Kay

RRT, MBA, MJ, CHC, CPC-A Chief Compliance Officer St. Christopher's Hospital for Children

I’ve worked with HMI employing them to conduct audits of physician documentation and coding. They have consistently produced quality work in a very timely fashion with reports that were well written and easy to understand. Communication has always been prompt and effective. I have such confidence in their work that, over the years, I brought them from my prior location to my current location. I would recommend HMI to anyone in need of accurate and timely coding or auditing.

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