Annual - Oversight Support Agreements
“Pay for what you need at the level of service you need”. Whether its ad hoc to your existing compliance department, a payor has come in to audit your practice and you need support, or you need a compliance oversight program, PCA is your solution.
PCA will help you legitimately maximize your revenue opportunities by learning how to bill, code and document correctly based on CMS/AMA 1995 and 1997 and other payor documentation guidelines. PCA support agreements are effective in maintaining compliance with required documentation and medical standards set forth by local, state and government regulatory guidelines.
ANNUAL SUPPORT INCLUDES:
Annual Provider Chart Reviews (10-20 records per provider)
- Desired sampling recommended by most payors
- Determine whether or not the CPT code selected was coded and documented correctly or incorrectly
- Identify any missed billables
- 4 on-site educational trainings
- 24/7 Ask a PCA Advisor Email Access
- Newsletters - Monthly Billing/Coding/Compliance Updates
- Government Random Record Request Support Services
- Review and advise appropriately
- Provide guidance and assistance with any formal audits
Oversight Services - Compliance
- Serve as compliance support providing published information as it relates to provider practices
- Advise/Assist in development of appropriate compliance plan policies & procedure
- Advise/Assist in identifying areas of risk and exposure
- Advise/Assist in Implementation of HIPAA standards, effective 4/1/2003
Oversight Services - Billing
- Liaison between facility and local managed care payors
- Provide billing department support, i.e. billing and coding changes
- Ensure provider/staff education
- Provide general billing department support
- Assist in the development/review of encounter forms for charging
NEW Clinical Services
- Investigate and provide support in securing CPT and ICD-9-CM codes and options for services considered
RVU - Provider Productivity
- Guidance/support in RVU setup
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