VRCM’s certified coders do retrospective and prospective review on provider’s clinical documentation to ensure that all appropriate diagnoses are captured, helping to identify gaps in data collection and submission thus improving your risk score accuracy and positively ensuring the delivery of high quality care to your members.
Our experienced clinical team of Nurse Practitioners and Coders abstract and accurately report on all HEDIS measures (as per NCQA technical specifications) related to Health Plans’ P4P and Star Program initiatives.
Health Plans can leverage our Certified Nurse Practitioners and coding resources in undertaking chart audits for Hospitals , DRG & DRG short stay audits & APC validation. Our stringent audit programs ensures our clients are controlling costs most often associated with incorrect billing and overpaid facility claims, while reducing overall facility adjudication and reimbursement expenditures.
VRCM delivers expert consulting, auditing, AR – Follow ups and Coding support services to our partners to evaluate and improve their financial performance, meet regulatory requirements, increase cash flow and streamline operations.
One Stop Access to Coding Solutions
Every HIM director is well aware, coding resources are in short supply. It’s an ongoing challenge to stay ahead of coding demands. ICD-10 training and testing requirements along with dual coding demands are straining the capacity of most organizations, while the coding specificity required by ICD-10 will make maintaining high data quality standards even more critically important.
ICD -10 Transition
VRCM leads the way for ICD-10 coding with a comprehensive readiness plan and transition steps. We have AHIMA-Approved ICD-10-CM/PCS employees and Trainers ready to implement the ICD-10 transition as per the latest CMS guidelines.
Our Value Proposition
Charts coded annually
Detection in Error rates