The process of coding a patient encounter has long been a complex, time-consuming endeavor, yet the demands to release bills quickly has meant organizations seldom have the luxury of fully optimizing their coded cases. As such, they’re often subject to unacceptable levels of revenue leakage, compliance exposure and inaccurate quality ratings.
Thanks to the powerful integration across our CDI, Physician Query, Abstracting and eValuator™ solutions, providers can better optimize their documentation and coding prior to bill release. This drives more accurate revenue capture and greater revenue integrity from existing resources.
Integration Right from the Start
With Streamline Health CDI, as soon as your staff assigns a working DRG, robust rules from CodeAlert will automatically begin assessing the case for accuracy issues that reflect potential opportunities and risks. This enables staff to address the issues earlier in the process. If additional clarification is needed, the integrated Streamline Health Physician Query feature makes it simple to electronically request and manage queries in the CDI process, reducing the need for coder queries.
In addition to DRG issues, CodeAlert will flag issues with Patient Safety Indicators (PSIs), Hospital-acquired Conditions (HACs) and infections (HAIs). Enabling staff to address these issues helps improve revenue accuracy while also ensuring quality ratings truly reflect the acuity and efficacy of care delivery.
Additional Integration to Drive Accuracy & Productivity
As the case moves into final coding, Streamline Health Abstracting ensures your team has access to all needed materials—working DRGs, CDI case review notes and supporting documentation, and all query requests and responses. CodeAlert is run on final coding to assess any modifications. Based on custom thresholds, you can route the case back to the coder, send to an auditor worklist, or both.
Automated Analysis of 100% of Your Coding
To fully optimize cases prior to billing, Streamline Health eValuator™ offers automated analysis of all inpatient and outpatient cases. By assessing each case — gauging for likelihood of change and financial impact of recommended changes— you can address under- and over-coding before billing to reduce revenue leakage, mitigate compliance exposure and optimize financial performance.
Once you’ve identified the cases best suited for auditing, eValuator Audit & Reporting provides a cloud-based, workflow-enabled platform to manage coding audits quickly and effectively. This solution integrates with existing systems and can be accessed by auditors and HIM management to quickly select cases for audit, move through the audit workflow and report on results in a matter of minutes. And it includes reports on a wide range of performance areas, including DRG, facility, individual coders and even physicians, giving you the actionable insight you need to optimize results!
Driving Quality Across Your Enterprise
Whether it’s presenting expert coding guidance to your CDI staff in real-time, compiling the complex reporting needed for CMS and state-based programs, or identifying the coded cases with the highest degree of risk or opportunity prior to billing, integrated coding solutions from Streamline Health will enable your organization to optimize revenue integrity from existing resources.