Client Overview:
A small nephrology practice in California facing issues with frequent coding errors and high denial rates for nephrology-related claims.
Challenges Faced:
- Frequent coding errors due to the complexity of nephrology procedures
- Slow claim approvals due to incorrect or incomplete codes
- High denial rate affecting practice revenue
PhysiAssist’s Plan of Action:
- AI-Powered Coding Tool Implementation: Integrated an AI-assisted coding system to improve coding accuracy, tailored specifically to nephrology.
- Enhanced Staff Training: Provided in-depth training on nephrology coding and payer-specific requirements for better accuracy.
- Denial Management Strategy: Addressed coding denials by reviewing past claims, identifying trends, and making necessary adjustments to processes.
- Regular Coding Audits: Established a recurring process for coding audits to ensure consistency and prevent coding errors.
Results:
- Achieved 96% coding accuracy
- Reduced coding-related denials by 35%
- Increased practice revenue with faster claims resolution