Wyoming Project
Carbon County Hospital
- Performed an assessment of needs
- Insurance Master Files
- Charge Codes
- CPT Codes
- Medical records coding
- Outstanding Accounts Receivable
- Repaired Insurance Master
- Corrected electronic plan code tables
- Changed billing requirements
- Units Required
- CPT Codes Required
- Non Covered charges
- Repaired Charges Codes
- CPT Code Cross reference
- Added Modifiers
- Fixed units
- CPT Codes
- Edited CPT Codes by Date
- Cross referenced Pharmacy Codes to NDC Numbers
- Repaired quantity errors
- Medical Records
- Repaired Diagnosis Codes to matched Procedures
- Anesthesia To Surgery Cross Reference
- Edited all diagnosis Codes By Date
- A/R Fix
- Rebilled unpaid Medicare up to year
- Rebilled unpaid Medicaid up to year
- Rebilled unpaid Commercial Insurance
- Fixed and rebilled all insurance with Coding errors , CPT errors, Modifier Errors, or Quantity errors
Outcome
- 90% of Insurance Companies billed electronically vs. 10%
- Unbilled accounts went from 1.5 Million to 500,000
- Recovered over a Million dollars in Billing errors
- Met with Departments for long term solutions
- OB/Gyn documentation to Increase Reimbursement
- Emergency Room to bill for all supplies and E/M Documentation
- Pharmacy for Unit errors in Chemo Drugs
- O/R for charge explosions and coding
- Laboratory and Radiology for CPT Codes and Modifiers