The Hierarchical condition category (HCC) coding division at Vee Healthtek was growing quickly. Staffed with over 500 coders, Vee Healthtek required efficiency in mass chart volume management with superior quality standards. A high demand for experience certified HCC coders increased wages and created challenges with recruitment and retention.
“My interaction with the patient in the exam room has been lost and replaced with large amounts of data entry on my part. I click away, staring at the screen and barely have time to make eye contact with my patient. This is the greatest loss, in my opinion.”
The Vee Healthtek coding team was tasked with identifying solutions to improve the delay in coding unbilled charts for a large hospital. The client was facing a financial crisis and had to significantly reduce staff.
Late in 2015, Vee Healthtek was approached by a new client having difficulty with their radiology coding system. They were depending on a computer-aided tool that did not adapt well to the type of radiology work being done, causing a three-month backlog.
A Vee Healthtek referral team was tasked with processing a large backlog of physician referrals for a large physician group in the U.S. Our client was experiencing long delays in processing physician referrals which led to a loss of patients, low patient satisfaction scores and ultimately, cash delays.
Most providers participating in risk adjusted contracts view risk adjustment optimization as a function of revenue enhancement. Most providers participating in risk adjusted contracts view risk adjustment optimization as a function of revenue enhancement.
The maturity of an organization determines its scalability and operational agility to adjust to shifting reimbursement structures, specifically alternative payment models.
The Challenge: Prohibitive labor cost and considerably higher turnaround time due to large number of manual adjudications resulting from mismatched information between enrollment data and provider data.
The Challenge: A cost intensive update process that required checking all data on provider information update form rather than ones which were changed (typically only 40%).
