ARK HIM Solutions

Auditing & Validation

 

CDI Audits: 

Our expert consultants will audit sample of records, based on specific areas of your choosing such as certain at-risk DRGs, missed query opportunities, etc. Based on the results of each audit, a written report and two hours of web-based education will be provided to the CDI and coding teams.

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• Revenue Integrity Audits

  • MS-DRG Validation Audit

  • APR-DRG Validation Audit

  • Medical Necessity Audit

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Domain Process, Procedures  and workflow Review:

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Work with your Physician liaison to review your program and help you to build  your policy and procedure manuals 

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ARK consultant will work with you to define and document best practice standards, processes, and protocols to create a manual that assists in driving CDI team performance. We’ll help you analyze and improve your CDI workflows and productivity standards to remove bottlenecks your CDI program is facing.

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Performance Improvement:

Our consultants help healthcare providers achieve and sustain robust clinical, operational, and financial results. Identify patterns, trends variances and opportunities and make it educational topics for Physician / CDI team.

Revenue Cycle:

Our team  supports revenue cycle clarity and results through technology optimization, performance improvement, and business process outsourcing.

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We help  your organizations to meet their revenue cycle and workforce management goals  through our dedicated experts.

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What is Clinical Validation?

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• The process of clinical review of a claim to see whether or not the patient really has the conditions that were documented.

• Addendum performed by a clinician, retrospectively after claims submission.
           The Recovery Audit Statement of Work states "this is NOT the coder’s responsibility"

• May result in claims denial when the clinical indicators in the record do not support the reported diagnoses and procedures.​

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