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About
Are You In Denial?
"Cleopatra Queen of Denial" TM
"Cleopatra Queen of Denial" TM
At present, payers are denying claims and services based on clinical validation denials and coding targets that are becoming more creative and voluminous each day.
Hospitals take a hard hit to their revenue stream while experiencing significant strain on HIM resources. Many denials go uncontested, due to being ill-equipped from a resource
At present, payers are denying claims and services based on clinical validation denials and coding targets that are becoming more creative and voluminous each day.
Hospitals take a hard hit to their revenue stream while experiencing significant strain on HIM resources. Many denials go uncontested, due to being ill-equipped from a resource and technology standpoint to efficiently manage the influx of denials, thus costing hospitals millions in revenue a year unnecessarily.
Likewise, inadequate resources to audit prepayment claims lead to prolific needless denials and sub-optimal compliance.
"Cleopatra Queen of Denial" TM
"Cleopatra Queen of Denial" TM
"Cleopatra Queen of Denial" TM
Cleopatra Denial Prevention and Management Tool is a cloud-based application that leverages the combined resources of technology, payer algorithms and HIM and Clinical expertise to deliver improved financial and compliance initiatives for your revenue cycle team.
Cleopatra eliminates the need for countless spreadsheets and entry into mul
Cleopatra Denial Prevention and Management Tool is a cloud-based application that leverages the combined resources of technology, payer algorithms and HIM and Clinical expertise to deliver improved financial and compliance initiatives for your revenue cycle team.
Cleopatra eliminates the need for countless spreadsheets and entry into multiple applications (all of which slow productivity and clog the revenue stream) by integrating a smart workflow replete with templates and resources for efficient auditing and appeals. Dashboards with granular reporting allow for beneficial clinical documentation feedback and invaluable educational opportunities.
Solutions
Solutions
Solutions
Call it counter-surveillance ...
Having been on the payer side, we are aware of their tactics. We employ similar analytics and audit techniques designed to protect your bottom line and support your revenue cycle while providing resources to effectively manage and optimize workflow.
DRG Review and Coding Quality Audits
Let us perfor
Call it counter-surveillance ...
Having been on the payer side, we are aware of their tactics. We employ similar analytics and audit techniques designed to protect your bottom line and support your revenue cycle while providing resources to effectively manage and optimize workflow.
DRG Review and Coding Quality Audits
Let us perform an analysis of your documentation, coding and billing to identify clinical indicators for SOI, ROM quality assurance with DRG accuracy and optimization. We use our proprietary and legendary tool "Cleopatra" to get down to the nitty-gritty of Quality Assurance.
Coding and Clinical Validation Appeals
Overwhelmed with third party recoveries? We got this! Cleopatra effectively prevents and manages denials while optimizing workflow. Cleopatra’s granular reporting targets and solutions the deficiencies leading to prolific denials.
Medical Necessity Audits
Cleopatra quickly identifies procedures and services that are subject to CMS or other payer's Medical Necessity audits based on NCD, LCD and Clinical Policy Guidelines before they are denied. Deficiencies are corrected in real-time to save back-end denials and massive revenue loss.
Our Team
Solutions
Solutions
An Eye on Revenue Cycle Improvement...
HIM Analytic Solutions LLC, based in South Florida, is a seasoned group of clinical, coding, billing and compliance experts and advocates proficient with physician and hospital revenue integrity and preservation.
Our physician advisors, registered nurses and HIM professionals, certified by AHIM
An Eye on Revenue Cycle Improvement...
HIM Analytic Solutions LLC, based in South Florida, is a seasoned group of clinical, coding, billing and compliance experts and advocates proficient with physician and hospital revenue integrity and preservation.
Our physician advisors, registered nurses and HIM professionals, certified by AHIMA, AAPC or ACDIS proficiently apply CPT/HCPCS, DRG and medical necessity strategies that successfully challenge recovery auditors through strict adherence to official coding conventions, guidelines, official coding advice and clinical validation principles widely accepted in clinical practice. Our consultants are hand-picked according to stringent criteria to ensure our clients are getting the cream-of-the-crop.
The by-product of HIM Analytic Solutions:
- Identify gaps in documentation
- Justify medical necessity
- Streamline and optimize workflow
- Maintain compliance
- Preserve Revenue