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Axea Solutions, Inc. 5755 North Point Parkway, Suite 94 Alpharetta, GA 30022
855.424.4249 info@axeasolutions.com www.axeasolutions.com
Contact Axea Solutions for practical, experienced-based outcomes.
At Axea Solutions, we are driven to optimize the financial performance of healthcare organizations through coding, reimbursement, and revenue cycle enhancements. Axea Solutions’ revenue cycle professionals average over twenty years of experience. We are able to offer recommendations for remediating challenges in a revenue cycle, identify areas for improvement and positively impact our clients’ financial success.
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ICD-10 • Classroom and Online Education • Planning, Readiness Assessment and Implementation • Post Implementation Management • MSDRG Shift Evaluation • Productivity and Staffing Analysis • Coding and Billing Backlog Resolution
Revenue Cycle Management • Process Reviews and Improvement • Denial Review and Management • Edit Management Billing and Coding • Chargemaster Review and Management • Case Mix Index Analysis • Financial Analysis
• System Implementation Assistance • Research Billing Issues and Edits • System Functionality Optimization • Affordable Care Act - Affected Process Review
Coding Review and Billing
• Coding Review and Risk Assessments • Clinical Documentation Improvement • Coder and Physician Education • RAC and Other Payer Audit Assistance
Virtual Coding
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Staffing Assurance Production Assurance Compliance Assurance Axea Knowledge Base Axea Tool Box
Advance. Your path to ICD-10 success.
ICD-10 Classroom and Online Education Provides levels of education for all healthcare professionals: • • • •
Executive Awareness Physician Awareness Departmental Readiness Advanced Coder and CDI Education
Planning, Readiness Assessment, and Implementation Work plan preparation and identification of organization issues for ICD-10 implementation. Pinpoint issues that relate to training, systems, process changes, performance indicators, human resources, availability of personnel, and payer testing. Develop and manage dual coding initiatives. Examine impacted areas through MS-DRG financial analysis. • Department specific assistance with process, system, and training issues. Continual management and monitoring of program plan developed during the ICD-10 planning. • Healthcare provider coding education using media tailored to the healthcare organization. • Implementation and execution of dual coding strategies for ICD-10 readiness. Post Implementation Management Assistance with post implementation challenges affecting the revenue cycle. • • • • • • • •
Process Review Revision of Key Performance Indicators for the Revenue Cycle Service Line Management (Business Analytics based on ICD-10 data) Physician documentation review Billing edit review and denial management Coding and billing back log resolution Coding Education and or refresher courses Physician documentation education
MS-DRG Shift Evaluation Provide financial analysis identifying the risk associated with the ICD-9 to ICD-10 transition. Productivity and Staffing Analysis Coding and Billing Backlog Resolution
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Revenue Cycle Management Process Reviews and Improvement Provide process review of revenue cycle to identify areas of inefficiency and improvement. Identify system and operational issues in addition to training opportunities. Assistance with special projects that take staff time away from daily activities. Denial Review and Management Identification and remediation development for specific denial issues. Management of denial and issue resolution. Provide feedback for affected processes and operations. Edit Management Billing and Coding In order to reduce a hospital’s prebill edit queue we provide expertise in processing coding, billing, admitting, and scheduling related edits. Expertise on various hospital information systems to resolve claim edits, release bills, and improve cash flow. Chargemaster Review and Maintenance Provide review of chargemaster to identify any inaccurate revenue and CPT code assignment. Perform revenue and usage analysis as well as sample specific claims for charging accuracy. Case Mix Index Analysis Identify issues affecting the case mix index such as medical and surgical, volume of services, and geographical considerations. Providing strategic recommendations for Case Mix Change. Financial Analysis Financial analysis for mandated governmental reimbursement changes. Provide impact to current operations and suggestions for process changes to mitigate any negative impact. These include: • • • •
Two Midnight Rule OPPS updates Quality Indicators Managed Care contract financial performance analysis
System Implementation Assistance • Electronic Health Record • Manage computer assisted coding transition and edit remediation Research Billing Issues and Edits Research billing has a unique set of requirements and issues. We provide staff trained in the specifics of research billing to resolve work queue edits as well as provide optimal processes for data flow. System Functionality Maximazation Provide optimal workflow and reduce errors with the identification of ways to maximize the use of current system functionality and identify any missing functionality. Affordable Care Act-Affected Process Review Examine areas affected by the Affordable Care Act such as front office processes, eligibility, co-payment management, and benefit gaps. Analyze functions to decrease disruption and patient liability shortfalls. Implement and monitor improvements and financial impact.
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Coding Review and Billing Coding Review and Risk Assessment Review records to ensure reported billing codes are supported by medical record documentation, using methodologies based on the client’s needs. If coding audits and/or risk assessment have not been performed within six months to a year, the review involves a baseline assessment. Frequency of review can change to monthly or quarterly. Some clients choose a 100% prebill audit for identified risk areas. Clinical Documentation Improvement Review records to identify areas for clinical documentation improvement. Establish program, provide documentation materials, and monitor results. Coder and Physician Education Education for coders and physicians to improve coding and documentation relating to major changes in the reimbursement system. RAC and Other Payer Audit Assistance Provide audit assistance for coding denials as it relates to RAC and other payers. Identify reoccurring issues for improvement opportunities and give feedback to affected departments. Assist in managing deadlines related to these third party reviews.
Virtual Coding Staffing Assurance • Articulate and document the essential qualities of a successful Coder. • Support Coder candidate screening. • Assist new Coder orientation and production onboarding. • Support Coder performance management. • Offer best practice insight into coding departmental incentive programs. • Engage in direct mentorship for select coding staff. • Fulfill ongoing Coder, process, and production audits for performance improvement. • Support Coder career path development planning. Production Assurance • Work with HIM management to establish production targets for the specific institution. • Perform current operational benchmarkings to set standards for improvement. • Design production improvement plans for each Coder. • Identify production output implications for the department and individual Coders. Compliance Assurance • Partner with Administration, Compliance Management, and HIM Management to establish set parameters for compliance performance. • Map compliance milestones across a calendar period for tracking and accountability. • Deliver Orientation, Training, and Education offerings in HIPAA and ICD-10. • Provide ongoing remedial training and support. • Support certification management for the institution and Coders.
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The right team: Axea Solutions The right tools: video, audio, and interactive.
Axea Knowledge Base
The Axea Learning Approach accommodates diverse learning styles with courses that utilize a variety of video, audio, and interactive teaching tools ensuring effective knowledge transfer and on the job application. Every ICD-10 Course on the Axea Knowledge Base is developed by our AHIMA approved ICD-10 Educators. Each of our educators has over 20 years of hands-on experience in the Health Information Management industry and connect intimately with your business challenges. Each course is structured to ensure learner success and the highest return on your training investment.
Axea Toolbox • !CD-10 Coder Guides for Each Course • ICD-10 Case Studies for Each Course • ICD-10 CDI Documentation Prompters • ICD-10 Physician Specialty Documentation Guides • Coding/CDI Review Databases • Edit Tracking System • Hospital Acquired Condition Tracker *All tools can be downloaded to handheld devices.
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Axea Solutions, Inc. 5755 North Point Parkway, Suite 94 Alpharetta, GA 30022
P 855.424.4249 info@axeasolutions.com www.axeasolutions.com