Trained clinical personnel perform an in-depth and confidential review of patients' medical records and correlating itemized billing (UB04) to identify appropriate and accurate billing. MCAS is designed primarily to report and/or identify the statistical accuracy of clinical activity, charge linkage and hospital income impact. Specific areas reported are:
Appropriate coding assignment (HCPCS/CPT, ICD-9-CM, DRG)
Documentation quality issues
"Medical Necessity" issues
Appropriate revenue and HCPCS/CPT code linkage
Modifiers
The primary benefits are to recover significant working capital and monitor billing compliance.
MMP, Inc. offers a no-cost risk study to determine collaboratively the needs or areas of risks to be addressed through specific services.
