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Axea Solutions 5755 North Point Parkway Alpharetta, GA 30022 USA

P 855.424.4249 F 000 000 0000

Contact Axea Solutions for practical, experienced-based, actionable quality outcomes.

Axea Solutions Defines Quality Organizations often view quality by the outcome of a project, the level in which key performance indicators are met, or even a simple accuracy rating. While these components are helpful in measuring quality, they don’t always translate to a clear overall picture of an organization’s quality health. At Axea Solutions, we believe to define and deliver quality services you have to look at people, processes, and outcomes to measure the success of a project, program, or system transformation.

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ICD-10 • Planning, Readiness Assessment and Implementation • Post Implementation Management • MSDRG Shift Evaluation Revenue Cycle Management • • • • • • • •

Process Reviews and Improvement Denial Review and Management Edit Management Chargemaster Review and Management Case Mix Index Analysis Financial Analysis Research Billing Issues and Edits System Functionality Maximization

Coding Review Education • • • •

Coding Review and Risk Assessments Clinical Documentation Improvement Coder and Physician Education RAC and Other Payer Audit Assistance

Analytics • Quality Monitoring and Outcomes Data • Affordable Care Act - Affected Process Review Virtual Coding Management • • • • •

Staffing Assurance Production Assurance Compliance Assurance Axea Knowledge Base Axea Tool Box

ICD-10 implementation. Plan for the road ahead.

ICD-10 ICD-10 Planning, Readiness Assessment, and Implementation Work plan preparation and identification of organization issues for October 1, 2014 ICD-10 implementation. Pinpoint issues as they relate to training, systems, process changes, performance indicators, human resources, availability of personnel, and testing with payers. Develope and manage dual coding initiatives. Examine impacted departments through MS-DRG financial analysis. • Support includes department specific assistance with process, system, and training issues. Continual management and monitoring of program plan developed during the ICD-10 planning phase to each affected department. • Healthcare provider coding education using media tailored to the healthcare organization. • Implementation and execution of dual coding strategies for ICD-10 readiness.

ICD-10 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 management 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.

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Revenue Cycle Management Process Reviews and Improvement Provide process review of each 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 Denial reason identification and remediation development for specific denial issues. Management of denial and issue resolution. Provide feedback loops for affected processes and operations.

Edit Management 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 all or portions 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 Pinpoint issues involving case mix such as medical surgical mix, volume of services, and geographical issues. Identification of coding quality issues.

Financial Analysis Financial analysis for 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

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 Provide optimal workflow and reduce errors with the identification of ways to maximize the use of current system functionality and any missing functionality.

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Coding Review and Education Review and Risk Assessments Review records to ensure reported billing codes are supported by the medical record documentation. This service is provided using methodologies based on the client’s specific needs. If coding audits and or risk assessment have not been performed within the past six months to a year, the review involves a baseline assessment. Depending on the client’s needs this 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 both coders and physicians to improve coding and documentation knowledge of the staff based on a coding audit or for major changes in the payment system. This education can be offered quarterly, or as needed. ICD-10 education will be critical during the current fiscal year for most clients.

RAC and Other Payer Audit Assistance Provide audit assistance as it relates to RAC and other payers with documentation and appeals. Identify recurring issues for improvement opportunities and give feedback to affected departments.

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Analytics Quality Monitoring and Outcomes Data Identification of Quality Reporting Program issues and resolution. This process includes: • Correct Present on Admission indicator reporting • Sufficient documentation to determine POA • 30 day mortality and readmission capture of information

Affordable Care Art - Affected Process Review Examine areas affected by the Affordable Care Act such as front office processes, eligibility, copayment management, and benefit gaps. Analyze functions to decrease disruption and patient liability shortfalls. Implement and monitor improvements and financial impact.

Virtual Coding Management Manage the core functions of coding by providing oversight and feedback by providing daily status dashboards to executives.

Staffing Assurance • • • • • • • •

Articulate and document the essential qualities of a successful Coder. Support Coder candidate screening. Assist new Coder orientation and production ramp-up. 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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Axea Knowledge Base Hospital and physician web based subscription for ICD10 and other training.

The Axea Learning Approach

accommodates diverse learning styles by utilizing a variety of teaching tools, including video, audio, and interactive exercises to create courses which ensure effective knowledge transfer and on the job application. Every 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 the highest opportunity for learner success and the highest return on your training investment.

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The right team: Axea Solutions The right tools: Video, Audio,and Interactive

Axea Tool Box • Coding Review Database • Hospital Acquired Condition Tracker • Clinical Documentation Improvement Database • ICD-10 Documentation Review Database • Edit Tracking System • Axea Knowledge Base

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Axea Solutions 5755 North Point Parkway Alpharetta, GA 30022 USA P 855.424.4249 F 000 000 0000

Axea Solutions Service Menu  
Axea Solutions Service Menu