RED BANK, N.J., Oct. 17 /PRNewswire/ -- Recognizing that most coding professionals today do not have an adequate tool to identify uncoded diagnoses and procedures in the patient record, Innovative Health Solutions, (IHS) a leading provider of coding, compliance, reimbursement and information management solutions, is rolling out the nation’s first web-based automated chart selection system this week during the 77th annual conference of the Association of Healthcare Information Management Association (AHIMA) in San Diego.
Called DRG FOCUS(TM), the new product has been designed to complement encoder use, according to Frederick Stodolak, chairman and CEO. He said the new system hierarchically scans all inpatient cases and goes on to flag those appearing to have a high clinical coding, financial and statistical probability for a discrepancy.
“We recognized a gap in the HIM marketplace,” said Mr. Stodolak. “Our company develops and distributes encoding software to hundreds of hospitals each year but we realize that the encoder is only as good as the information in the chart at the time of coding.”
According to Mr. Stodolak, most hospitals need to submit their inpatient bills within a short billing cycle of five days or less to maintain cash flow and as a result, bills often do not reflect accurate coding and reimbursement. He noted that the higher the patient acuity or intensity the higher the probability that information is still sitting on the floor at the time of coding.
“With our web-based system hospital coding, professionals or consultants can now utilize our DRG FOCUS system to select from hundreds or thousands of cases those records having the highest probability for a coding discrepancy and do so on-site or remotely,” said Mr. Stodolak. “As a result, coding professionals can be certain that uncoded procedures or diagnoses in the chart will be quickly and accurately identified, thus assuring proper reimbursement and more accurate clinical measures.”
“DRG FOCUS can be used prior to billing on a daily, concurrent basis or it can be used retrospectively as an audit tool,” said Mr. Stodolak. “Edits have been designed to identify cases with the potential of being not only under-coded, but those which may have been over-coded, which means that DRG FOCUS becomes a tool for compliance and reimbursement.”
The new system includes a DRG Grouper and Pricer which will accurately calculate, based on individual facility ID, the difference in reimbursement from the originally coded DRG to any final DRG, once the coding changes have been made in the system. Based on these changed records, the user will be able to generate useful management reports including financial impact analyses by coder, physician, reason for coding change and more.
ABOUT Innovative Health Solutions
Innovative Health Solutions is a leader in the development of coding, compliance, reimbursement and information management systems. Today, over one fourth of the nation’s healthcare providers, major IT vendors and managed care organizations use IHS systems and solutions to increase revenue, optimize reimbursement, enhance decision support, improve cash flow and ensure coding compliance. IHS products help customers achieve optimal financial results in an era of ever-diminishing resources and expanding regulatory complexities.
Innovative Health Solutions
CONTACT: Fred Stodolak of Innovative Health Solutions, +1-732-392-8210,fstodolak@ihsinfo.com
