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Compliance Consulting Services:

With regulatory bodies imposing increasingly stringent standards, compliance in the health care industry has never been more crucial. In response to this, health care payors and providers must implement new compliance initiatives to improve and strengthen their internal operations. In an effort to help these organizations, IMEDECS has created compliance services to support these needs.

The components of this product are based on the needs of your institution. The product is strictly preventative and exists for the purposes of development, internal analysis and strengthening of a compliance program.

The Components:

A. Coding Reviews & Monitoring

1. Retrospective Audit - reviews performed and assessed for accuracy of correct coding practices
2. Review of Explanation of Medical Benefits (EOMB) statements and claims denials.
3. Annual Reassessments for Ongoing Vulnerabilities and Risk.

B. Training and Education

IMEDECS provides customized seminars for your staff. The sessions can address any specific coding topics of interest to your healthcare organization. Some topics may include:

• Explanation of current CPT/ICD-9 and Medicare changes.
• Understanding claim denial reasons and overcoming medical necessity denials.
• Customized specialty specific topics
• Medical record documentation.

C. Administrative/Clinical Compliance

1. Vulnerabilites/Risk Assessment Reviews.
2. Policy and Procedure Development.
3. Billing/Collection Procedures including Claims Denials/Appeals Process.
4. HIPAA Compliance.
5. Annual compliance training for all employees.
6. Corporate Integrity Agreements.