With over a decade of first-hand experience in both the insurance and health care industry, as well as invaluable relationships with our clients, Washington & West offers premier consultation to health care providers. Providing our clients with a fresh perspective into their processes and insight into possible methods of improvement, develops an active and personal partnership that emphasizes the importance of all denial management services offered by Washington & West. We offer comprehensive written feedback with fresh insight and detailed, systematic recommendations for the optimization of your healthcare system. We perform all audits in accordance with HIPAA and all other state and federal regulatory requirements.
Physician Education for Denial Prevention
Inadequate physician documentation is the most significant problem among services that are at risk for denial. Washington & West offers a competitively priced documentation improvement program that can – from a physician-friendly, supportive perspective – enhance physician’s understanding of what Medicare and other payers require in medical records. This program is designed to augment (not duplicate) clinical documentation improvement programs that are focused on ensuring physicians provide enough specificity in their diagnoses and procedures to enable proper coding and to justify medical necessity. Washington & West strives to develop physician documentation improvement plans that are unique to each provider’s needs in order to facilitate complete and accurate physician documentation. Improving your facility’s clinical documentation can ultimately ensure a steady revenue stream by preventing claim denials.
A hospital’s chargemaster should accurately reflect every procedure, service and supply in the facility. Washington & West’s coding team evaluates the effectiveness of your chargemaster and reviews for accuracy of HCPCS/CPT and revenue codes. We identify errors and work with facility management for more accurate coding, charging and billing for each department or practice. We perform monthly reviews and provide specific, brief educational sessions centered on the previous month’s findings.
In addition to the consulting services listed above, Washington & West is pleased to offer additional consulting in the following areas:
- Coding education for denial prevention
- Payer contract reviews
- RAC and ZPIC proactive review
- ICD-10 readiness
- Medical necessity denial management
- Inpatient and outpatient operational review
Our consulting services take a variety of forms, from workshops and webinars, to in-depth analyses of your operations and action-oriented plans to build better systems. We tailor our services to your specific need and put the right team in place to assess, make recommendations, and provide ongoing support to your team.