Permanent Fix to Physician Billing Mistake
A complex of hospitals was having problems with physicians upcoding for services when the procedure required their physical intervention. This upcoding was not consistent with billing protocols. RDA developed a process of education and monitoring that allowed the hospitals to know every physician’s individual compliance rate and remediate outcomes in real time. After a Beta test in one department the process was rolled out across the organization. The process provided an ongoing error reduction mechanism reducing mistakes and creating an ongoing factual audit review. Further, we assist in system designs to encourage and reduce billing mistakes at all levels of the organization.