Developed to provide physician and practice assessment services to include overview of office and inpatient services coded and billed, review office superbill, review office/staff functions and processes, and provide physician and office staff education. Coding will be reviewed against criteria established by the American Medical Association and adopted by the CMS, the American Medical Association’s coding guidelines through its publications CPT Assistant and Coding Clinic for ICD-9-CM.

HMI consultant specialists perform the following: 1) Review medical records (Medicare only) for documentation, coding, and billing assessment; 2) Review the practice superbill and/or chargemaster for updating ICD-9-CM and CPT-4 code assignments and descriptions; 3) Review CDM to perform rate analysis (comparison of current charges to Medicare allowable payment rates); 4) Review practice policies, billing processes, and assess the functions of office personnel; and 5) Perform education in-service (1 hour session) for office/coding staff and/or physicians.

Value added benefits:

Confidence in meeting documentation guidelines
Confidence in coding and billing practices
Complete rate analysis
More knowledgeable staff and physicians