Expert on ambulatory payment classification system and facility coding in the emergency department.Trained thousands of emergency physicians how to improve documentation and hundreds of coders how to code emergency medicine.Expert witness for the Federal government on emergency medicine coding fraud and abuse.Member of the American College of Emergency Physicians Subcommittee on Coding and Nomenclature. Decades of experience coding for and training emergency medicine physicians to improve documentation and coding compliance.Directed by a nationally recognized emergency medicine coding and reimbursement expert who is both a certified coder and an emergency room registered nurse.All this adds-up to the potential for suboptimal coding, missed billable services, backlogs, compliance exposure, and lost revenue. Hospital HIM directors and managers have to priortize their limited resources, and the bulk almost always goes to the higher-dollar-valued inpatient services where one discharge can be equal to 100 or more ED visits. Only a fraction of overseas coders are certified, and even fewer have multiyear emergency medicine coding experience. More and more billing companies send their coding and back-office work to subcontractors in developing nations overseas to bolster their profit margins. Unlike a dedicated coding company, billing companies can only give the coding function limited resources and attention. Blling companies are in-business to make a profit and their operation also involves billing, data entry, accounts receivable follow-up, payment posting, secondary and balance billing, etc. Their coding is done remotely, usually by billing companies or hospital medical records staff. Unlike most other specialties, Emergency Physicians generally have no employees. Locum tenens and part-time non-equity doctors often fill the schedule. Considering the number of patient visits, the ED coders must have an intimate understanding of what happens in the ED and they must be continuously inserviced and Q/A reviewed to avoid institutionalizing misunderstandings and thus making coding errors an “intergenerational” legacy. Unfortunately the physicans’ notes are not always expansive as they need to be discrepancies with the doctors’ notes, the nursing notes and the doctors’ orders are commonplace. Documentation must be precise because nothing can be assumed. Diagnostic coding is critical to present the medical necessity for each. Surgical procedures are performed and diagnostic tests are ordered. This fast paced high-volume specialty encompasses elements of primary care E&M services up to trauma services.
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