The impact of CPT, ICD-9, and HCPCS coding and billing on your organization's financial performance is tremendous.
Prudent health care organizations use coding information to:
- Bill and be reimbursed for services
- Monitor clinical and business patterns
- Negotiate third-party payer contracts
- Calculate physicians' W-2 compensation
If coding is not performed correctly, data will be faulty, poor business decisions may result, and overall revenue will not reflect services provided. Not only does problematic coding have a revenue impact, inefficient billing processes increase costs directly (staffing, re-submissions, high accounts receivable) and indirectly (frustration levels, low morale).
Wipfli assists health care organizations to ensure their coding is accurate and that revenue and compliance processes are efficient and effective. We are experts in the following areas:
Medical Practices
(independent or health-system owned)
- Revenue Cycle Enhancement
- CPT and ICD-9 coding
- Evaluation and Management (E/M) code utilization analysis
- Revenue and compliance policies and procedures
- Compliance programs
- Payer reimbursement analysis
- Internal audit program development
- Perform provider-based analysis for hospital-owned practices
- Provide Rural Health Clinic and Federally Qualified Health Center analysis
- Prepare Medicare and Medicaid cost reports
- Chart documentation
- Billing and claims review (audits)
- Fee schedule analysis and Relative Value Unit (RVU) development
- Third-party payer compliance
- Focused physician education
- Staff training and mentoring
Hospitals / Health Systems
- Revenue cycle enhancement
- Accounts Receivable (A/R) management
- Case mix management
- Charge master redesign
- Medical record documentation and ICD/CPT coding
- DRG and APC reimbursement
- Billing compliance
- Performance improvement
- Managed care contract evaluation
- Health information (HIT) assessment and management
- Utilization management