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The FIRM provides professional claims billing services for individual providers, clinics and facilities. We service all disciplines of practice, i.e., medical, dental, diagnostic testing, chiropractic, physical therapy, optometry/ophthalmology, mental health, chemical dependency, and durable medical equipment.

We offer specialty services such as consultation, collections and appeals, contracting and credentialing, verification and preauthorization and personal injury settlement negotiating. We offer form development and revision services, office reorganization and personnel training.

We have extensive experience in all areas of commercial insurance, Workers Compensation, personal injury, Third Party Administrators, Medicare, Medicaid, and other state and federally funded programs. We offer personalized services designed specifically to meet your needs.

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ICD-10 conversion had minimal impact on hospitals’ denial rates, report finds

Written by Kelly Gooch | June 29, 2016 After three delays and much industry opposition, the United States' healthcare industry transitioned Oct. 1, 2015, to ICD-10, increasing the number of diagnostic codes from 13,000 to 68,000. The transition was expected to have far-reaching, disruptive consequences, such as delays in billing and coding, the potential for increased payer denials and accounts receivable and the possibility of decreased cash collections. However, new data shows the conversion minimally impacted cash collections, initial denial rates and days in accounts receivable, according to a report from public accounting, consulting and technology firm Crowe Horwath. This data came from Crowe Revenue Cycle Analytics, a benchmarking solution that compiles and organizes a daily feed of transactional-level data from the patient accounting systems of nearly 600 hospitals. These reports outline findings based on an assessment of key performance indicators related to billing and coding, accounts receivable and denials. The Crowe report details the analysis of data examined through March 31. Here are four findings from the report. 1. On average, there was minimal impact on cash collections, initial denial rates and days in accounts receivable due to the ICD-10 conversion; however, there were delays in inpatient billing and coding, Crowe said. This resulted in a 10.1 percent increase in inpatient discharge and not final billed days from October through December 2015, compared to the same period in 2014. 2. Crowe observed a temporary increase in denial claim adjustment reason code 11, indicating the diagnosis is inconsistent with the procedure, for a small number of hospitals. As a percentage of total gross patient services revenue, this denial reason code spiked from October through December 2015. Brian Sanderson, managing principal of Crowe healthcare services, said [...]

Good, Bad Trends in ICD-10 Coding Accuracy: Early 2016 Data Revealed

The Firm Services has the answers to all your ICD-10 issues. Written by Eileen Dano Tkacik | Monday, 20 June 2016 20:00 A recent data set gathered from 300 coders at 50 health systems was revealing with regard to ICD-10 coding accuracy thus far following the October 2015 implementation. The data exposed both good news and bad news for health information management (HIM) directors and coding managers. The good news is that coding accuracy is increasing slightly after eight months under ICD-10. But conversely, coding accuracy is nowhere near the 95-percent standards long ago established under ICD-9. So while accuracy ratchets up, the data demonstrates that many coding quality issues continue to persist. Measuring ICD-10 Quality Thus Far Our coding accuracy data was compiled from 300 coders using Central Learning, a Web-based coder assessment tool, and it includes input from experienced coders as well as coders-in-training. Fifty health systems are represented in the data, providing a broad-based assessment. We compared coder accuracy from the first quarter of 2016 (Jan. 1-March 31) to midway thru the second quarter (April 1 to May 27) to identify recent, timely trends in coder accuracy. Here is the most current benchmark of where we stand midway through the second quarter, as compared to the first.  As you can see, there has been an upward trend in coding accuracy, and we expect this to continue. Actively monitoring code quality, either through monthly coding audits or automated coder knowledge assessments, is critical to mitigate coding denials and revenue recoupment, as payor denials and recovery audits are expected to increase. Five Areas of Coding Accuracy Concern Digging deeper into the data from the first quarter, we pinpointed five areas in which [...]

ICD-101: Learn how to improve ICD-10 coding productivity

The Firm Services let us help you Code On ! by CARL NATALE - ICD 10 Watch.com - 10:32 AM Learning the  ICD-10-CM/PCS code set is going to take a lot of time. Cutting back on training is tempting when the ICD-10 implementation budget grows. Especially when you consider the hit to medical coding productivity that's coming. Which would be a mistake according to an American Academy of Professional Coders (AAPC) tip sheet: "The better educated and trained everyone is, the less of a productivity hit your practice will suffer, and a quicker recovery may be realized once we implement ICD-10." Here are some more tips to help you achieve ICD-10 proficiency: Have a Heart – Cardiac Overview: Coding cardiac conditions will be require brushing up on anatomy and physiology. (ICD-10 Tips and Resources - AAPC) Orthopedic Coding in ICD-10-PCS: Allografts and Autografts (Medical Billing and Coding Certification) Another ICD-10-PCS multiple procedure guideline: "Multiple procedures can also be reported during the same operative session when the physician performs multiple root operations with distinct objectives on the same body part." (ICD-10 Trainer) Differences from I-9 to I-10: Ventilation times: ICD-10-PCS has more options which might affect reimbursements. (IOD Blog) Use the (coding) force: Coding in ICD-10 Luke Skywalker's medical records. Hmmm. (ICD-10 Trainer) V84 to Z15: Don’t Expect Big Changes for Genetic Test Results: It's a one-to-one crosswalk. (SuperCoder Bolt) ICD-10-CM coding for late effects: How to report sequela codes. (ICD-10 Trainer) Questions about ICD-10 codes and reimbursement? Physician Credentialing and Revalidation ? or other changes in Medicare, Commercial Insurance, and Medicaid billing, credentialing and payments? Call the Firm Services at 512-243-6844 or credentialing@thefirmservices.com

The State of ICD-10 Implementation: Calm, and Qualms

ICD-10 LET THE FIRM SERVICES BOOST YOU OVER THE OBSTACLES                               Medscape Medical News- Robert Lowes  June 10, 2016 Now at almost the 9-month mark, the implementation of the new ICD-10 (International Statistical Classification of Diseases and. Related Health Problems, 10th Revision) diagnostic codes by physician practices resembles a calm, glassy stretch of ocean broken by a solitary shark fin. Yes, there is calm. By almost all accounts, the switch from the old ICD-9 codes to their more voluminous and complicated replacements has not produced a feared spike in rejected or denied insurance claims that would interrupt cash flow. Physicians who code claims and third-party payers that process them are mostly getting ICD-10 right. "We're not hearing from members that they are experiencing increased levels of denials," Robert Tennant, director of health information technology policy at the Medical Group Management Association, told Medscape Medical News. More succinctly, coding consultant and author Betsy Nicoletti told Medscape Medical News, "I haven't heard boo from my clients." However, a few experts have heard unsettling boos about rising denial rates, and almost everyone with something to say about codes and claims processing is apprehensive about what will happen after October 1. That date marks the end of a 12-month grace period set by Medicare and a number of large health insurers for tolerating less than perfect ICD-10 coding. If and when these payers bare their teeth over ICD-10, there could be blood in the water. There is another type of ICD-10 fallout to consider other than claims denials. A March survey by the Workgroup for Electronic Data Exchange found a slight decrease in productivity [...]