Ask An Expert: How Effective Coding and Case Management Can Benefit Your Bottom Line

When you seek advice on what your health system can do to benefit its bottom line, you look to the experts. We went straight to the source and sat down with Barry Matthews, Vice President of Health Information Management for HCTec. HCTec is a KLAS-rated leading provider of hospital IT and revenue cycle workforce optimization solutions, including specialized skills staffing, consulting and managed services.

How can a hospital improve patient care and maximize revenue without adding to its headcount?

Incorporate coding and case management under revenue cycle operations. Hospitals that are organized in this manner are continuing to see gains in revenue despite an everchanging environment. When you have clinical documentation improvement (CDI) and case management working together, you are able to ensure proper code use, keep patients on track for recovery, and reduce or eliminate readmissions. In value-based care, these tasks are critical to ensure maximum reimbursements are paid quickly and accurately, costs per patient are effectively managed, and penalties are kept to a minimum.

What can a hospital do to maintain quality of care and manage costs during high capacity situations, while continuing to support their full-time staff?

One-third of hospitals across the country are hiring skilled, outsourced consultants and seeing huge benefits across their health systems. Get in on their secret sauce! Hospitals are able to meet demand when experiencing ebbs and flows in patient census with a flexible, highly-skilled workforce who can help maximize revenue, identify trends and educate providers. Be sure to choose a partner that only employs top quality, U.S.-based coders, CDI specialists, and case management experts who are fully immersed in the latest technology and industry trends.

What is the best way for a hospital to find inefficiencies within their HIM operations?

A good first step is to start with an audit. This helps identify major pain points and the types of coding or clinical documentation errors being made, as well as the opportunities presenting across all of your health system’s departments. After an audit, work with your partner organization to develop a strategy to address the inefficiencies found, while staying within budget. Your partner should provide your physicians, staff, and management with education on how to identify routine coding missteps, communicate coding trends, and offer ongoing insights into coding best practices — all with complete transparency throughout the entire process.

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