FairCode in Action: Forrest Health - A Case Study

While in-person conferences are being cancelled or moved, FairCode continues to participate in the virtual world. Our healthcare associations need support more now than ever, and our provider community needs education and collaboration to react to the revenue crisis that COVID-19 has created in hospitals.

FairCode was happy to join the Q1 Healthcare Revenue Cycle Forum in July. Forrest Health, a FairCode client from Hattiesburg, Mississippi, joined the morning session with a case study to highlight their results. Lorie Mills, System Director of Coding and Clinical Documentation, reviewed her success story in addressing CMI and improving reimbursement.

Ms. Mills brought FairCode to Forrest Health in 2016 and has experienced significant progress in reimbursement and avoidance of denials as well as nearly a 7% growth in Medicare CMI. In calendar years 2018 and 2019, through FairCode's recommendations from their physician reviewers, Forrest added more than $3.6m to their bottom line with a 437% gross ROI. More recently, they've been able to manage through the difficulties of COVID-19 and have actually seen a slight increase in ROI during the pandemic.

It's get togethers like these (virtual or in-person) that will help providers learn from each other and continue to grow and thrive (or at least survive during these challenging times). Unique solutions such as FairCode, offering physicians trained in coding to clinically validate DRG assignments before a claim is dropped, are the hidden gems that come from networking and sharing ideas.

FairCode combines 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 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, case mix index (CMI) and bottom-line results. From clinical validationand 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. FairCodeaverages greater than 4:1 Gross Return on Investment.

http://www.faircode.com/