Record Processing

Processing & Reconciliation

As medical records are received they are distributed to the appropriate Document Processing Specialists. Records are counted, verified and carefully reviewed for completeness. Missing information is noted and entered into our Medical Record Tracking program. The batch of complete medical records is forwarded to the appropriate Account Manager for coding. Once per month, an Overdue Missing Information Report is filed.

Coding

HIMG takes great measures to provide the most accurate and compliant coding. Here’s a summary of what allows us to achieve our high standard.

Expert Personnel – Our Account Managers are highly-trained in regulatory compliance, strict coding guidelines and understand the importance of client-defined guidelines. Our coding methodology is insurance-specific, state-specific, diagnosis-specific and client-specific.

Attention to Detail – CPT, ICD-9CM and HCPCS codes are assigned by our Account Managers and are then entered into our computer system. Our system recognizes the procedure codes assigned and supplies the appropriate fee(s). Insurance providers are coded into an internal number assigned by carrier and address.

Specific Assignments – Most of the problems associated with incorrect coding are eliminated because our Account Managers are assigned specific facilities. They become familiar with the insurance plans prevalent in their hospital communities and constantly update our internal insurance maintenance software. This is essential to ensuring the “clean claim equals paid claim” philosophy.

Data Entry

Data entry of patient demographic data, insurance data and provider data is performed following the medical record processing and coding functions. Data is entered into our computer system and becomes the patient account. Once the account is established, it is automatically billed to the appropriate paying source. We also use “hash totals”, a method which ensures all CPT codes are properly entered.