Case Studies
Detailed review also led to identification of several other errors such as wrong patient coding, deleted codes, patient name mismatch among others.
THE PROBLEM
On account of its Consistent track record of delivering 95%+ Accuracy, VRCM was selected as an audit partner
THE SOLUTION
Error Classification | Count |
---|---|
Missed HCC | 8,105 |
Codes Deleted | 267 |
Wrong Patient Coded | 45 |
Wrong Bucket | 40 |
Codes Changed | 40 |
Date of Service Error | 20 |
Patient Profile -
Vascular complications and chronic heart failure (CHF), as well as other comorbidities
Risk Adjusted Payment
-
~200% increase in payments with all conditions coded as compared to missing HCC codes for chronic conditions