Author Topic: Procedure code Analysis  (Read 2909 times)

dfranklin

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Procedure code Analysis
« on: December 24, 2009, 05:32:58 PM »
Does anyone know of a software (where to get it) that we can use to analyize a provider CPT codes?  To be able to provide reports on them?

Michele

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Re: Procedure code Analysis
« Reply #1 on: December 26, 2009, 09:24:12 PM »
I'm not sure exactly what you're looking for.

Michele
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dfranklin

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Re: Procedure code Analysis
« Reply #2 on: December 26, 2009, 10:10:55 PM »
I found something from claimtek but you have to get their whole system to get this tool .  below is some info on it or you can go to their site at: http://www.claimtek.com/software_essential_cr_definition.html .  I am looking for something like this to provide as a benefit to my existing clients and also to prospects.  any ideas?

From Claimtek:
 It can analyze the losses incurred from rejected claims due to incorrect codes. This valuable tool works with the doctors' data to analyze entries and provide realistic revenue loss estimates arising from using incorrect codes. A code review process may end up saving doctors thousands of dollars annually in rejected claim fees.

As part of the ClaimTek marketing package, you will receive a special Business Survey form. You can send this form to healthcare providers to complete, which may help them raise questions about services and expenses in their own minds. This helps lead to the possibility that they will contact you for additional information. As encouragement for physicians and office managers to respond to your survey, you offer a complementary Procedure Code Review (PCR).

Basically, the doctor's office provides you with their current procedure code list. You enter their procedure codes into the MDCR software to analyze it. With one push of a button, the MDCR generates a comprehensive report showing the status on each code. This report also provides doctors with a vital financial summary as to how much money they may be potentially losing per year as a result of using invalid codes.

 The audit will also determine whether their procedure codes represent the appropriate levels of service as required by insurance companies and by the American Medical Association's manual entitled "Physicians' Current Procedural Terminology" (CPT).

oneround

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Re: Procedure code Analysis
« Reply #3 on: December 28, 2009, 10:30:56 AM »
I agree with dfrankling.  We use ClamTek when auditing our sites.  As with any software used for auditing purposes I do not believe that there is one that you can use without having to purchase the entire package unless, you do a manual audit by pulling all of the EOB paper and EDI denials and that can be a very long process.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare