The onslaught of the Corona Virus drove the Department of Health & Human Services to indefinitely cancel all elective surgeries. Prior to COVID-19, the elective surgeries made up the majority of many hospitals’ billing. The COVID-19 DRG bills have made their way through CMS and the private insurers, and now the coding and billing problems are beginning to surface. By ceasing non-essential surgeries, the government essentially reduced hospitals’ operating cash and forced the CFO to conduct furloughs. Many nurses, technicians and administrators were laid off due to cash flow problems. Other hospitals could not handle the loss of revenue and have shut down in recent months.
Since COVID-19, CFO’s are searching for ways to generate additional revenue for their hospital. One of their first stops is the revenue department where it’s time to tighten up the reigns and seek new and creative sources of revenue. After all, the revenue department will direct the financial future of the hospital. One way to generate revenue quickly is to focus on the prior years’ DRG billing. Specifically, allow a team of physicians trained in coding to perform medical chart reviews on the files selected by AI. The time is now to review past bills and resubmit them for billing after a trained physician recodes to the appropriate code.
FairCode increases clean claim ratios by combining the domain expertise of experienced physicians with modern data science and analytics technologies to increase hospital revenue. FairCode bridges the gap between a hospital’s attending physicians and hospital coders. The result? Patient acuity and Case Mix Index (CMI) are more accurately captured with the correct DRG, and hospital reimbursements adjust accordingly. DRG Validation and physician conducted medical chart reviews happen in real time, significantly impacting hospital quality rankings, CMI and bottom-line results. From clinical validation and chart reviews to payor denial defense, FairCode’s physicians and data scientists are part of a hospital’s coding team. Add FairCode to your existing CDI initiatives and see the difference. Outcomes are measurable and significant. FairCode averages greater than 4:1 Gross Return on Investment.