SERVICE BRIEF

Clinical Coding Solutions CONSISTENT QUALITY & TIMELY COMPLETION

ABOUT US iMedX was founded in 2002 and since then has become a market leader in the global clinical documentation industry serving over 200 Coding Customers. iMedX has over 3000 employees globally and counts some of the most prestigious acute medical and surgical in Australia and the US as their clients. Where relevant iMedX can leverage best practice from our parent company.

Since 2005 iMedX Australia has had an ongoing relationship with facilities of all complexity and sizes through the provision of coding services, and an outsourced services offering. Our aim is to partner with you, and to provide tailored solutions that will inform training, development, and best practice in coding accuracy and revenue outcomes for years to come, in accord with the high-quality care delivered to patients and patient complexity.

CODING SERVICES OFFERED

Discover a coding resource that meets your goals, operates smoothly within your system, and satisfies your need for dependable service. iMedX is structured and staffed to serve the healthcare industry exclusively, but more than that, our fresh approach ties our objectives to yours, netting you enhanced compatibility, compliance and performance.

Remote Coding Services Onsite Coding Services Clinical Coding Education Plans and follow (includes producing documentation queries) (includes producing documentation queries) up Education post audit

Onsite and Remote Coding Coding Audits including pre & Coding Optimisation Coding and Billing Audits Auditing and Coder Education post third party payer audits THE IMEDX TEAM AUDIT WORKFLOW

Led by Karen Dawson with over 25 years experience we have a Below is a summary of a typical Audit workflow for iMedX Clinical team of highly experienced Clinical Coders and Health Information Coding Audits. Managers with Australian and NZ experience. Karen provided the first external contract compliance audits encompassing Clinical Coding 1. Discovery and Billing, and this extensive experience has informed the approach and advice she and our team can offer clients from the planning stage • Consult Client of each assignment. 6. Outcomes • Confirm Start dates Inform Next Accurate revenue streams and protection of revenue gains are • Confirm Auditors Audit essential: • Confirm Audit Sample

• We only provide personnel with industry recognized qualifications, experience and a proven results driven track record. We are 2. Audit Sample Episodes confident in the calibre of our people.

• We also match our people with your specific business needs. • Briefing of Audiitors on client objectives • Select Audit Sample for Client • We are flexible in our approach – we can work remotely or onsite, or • Provide Audit Sample to Client both. • Provide Audit prep guide • We have effective oversight over your assignment both on and offsite, and our consultative feedback to clients is comprehensive.

• We do not just report outcomes – we provide solutions. 3. Review Clinical Documentation • We can also take that next step and assist with implementation of solutions, and provide education, including Clinical Coding • Audit Commences education. • Clinical Documentation reviewed • DRG Changes reviewed in conjunction with the Client • Rapid response and quality outcomes. • iMedX team provides daily feedback • Confident in the calibre of our people across all sectors – public and • iMedX generates Documentation Queries private. • Interviews with key personnel on process and resources

All clients will have an Account Manager, acting as a top-level point of contact for account queries for the duration of the assignment. 4. Feedback Our services are all backed by our inhouse Australian support team, • Agreement Reached re ? DRG changes including our highly responsive IT support. • iMedX provides daily observations and final feedback for Clinical Coding team

5. Review Outcomes

• iMedX provides feedback for Senior Executive team onsite • Produce Audit Report including education follow up summary

• The Audit process is tailored to client needs. • Audit report identifies good practices observed, standard of • Program can be targeted to specific specialities, focus on documentation for individual specialities, commonly identified documentation/doctor queries, or provide a baseline for education, discrepancies and training and development opportunities. or a combined purpose. • Concise, clear audit reports provided with solutions. • Programs are designed to encourage participation and feedbacks are interactive. • iMedX has a 15 year plus repository of benchmarking data. REMOTE CLINICAL CODING WORKFLOW

• Work hours, selection of Coders, and process tailored to client. • Onsite Clinical Coding is also an option if this is preferable or a site has paper records only. • Highly experienced Clinical Coders confident with remote coding. • Documentation queries completed by Clinical Coders. • “Clean Desk” process employed by Remote Clinical Coding team. • The flexibility to provide a combination of remote, onsite and audit • Long term, Short term or backlog Clinical Coding requirements assignments. completed.

1. Discovery 3. Go Live

• Consult Client and confirm KPIs • Clinical Coders begin services: • Client to provide Clinical Coding process • Coding of Episodes & documentation and manuals • Creation of Documentation Queries where applicable • Confirm start dates and volume of work required • Confirm Auditor assignment • Client to provide IT access documentation 4. Monitoring

• iMedX monitors daily throughput against KPIs 2. Service Preparation • iMedX provide daily and weekly progress update to client

• iMedX Brief Clinical Coders • Client provides system access logins • iMedX test connectivity and access to all systems

Experience The Unique Advantage To Clinical Coding With iMedX

• Dedicated Clinical Coding • Expert and dependable coding professionals from coding specialists

• Coder education • Remote or inhouse coding

• Coding audits/reviews iMedX offers experienced Clinical Coders and Auditors.

Our Auditors conduct comprehensive & interactive Coding Audit feedback sessions.

Targeted audits and education on specific specialities based on audit results, or any inhouse needs can also be part of an iMedX package of services. Coding Audit Case Studies

SITE A - PUBLIC, ACUTE HEALTH SERVICE Outcomes Case Mix: Complex, Tertiary Referral, Research and Teaching Hospital • Education required on specific Australian Coding Standards. Audit Sample: 200 Education plan created for Clinical Coders from findings, and implemented. $210k • Documentation Query process reinforced amongst Clinical Coders, In Identified Revenue resulting in greater revenue. • Clinician follow up regarding clinical documentation deficiencies.

SITE B - PRIVATE, ACUTE HEALTH SERVICE Outcomes Case Mix: Medium to high. Cardiac Catheter Laboratory, ICU, CCU • Documentation deficiencies leading to loss of revenue. Clinical Audit Sample: 200 specialities identified for education plan.

• Clinical Coders educated on writing of documentation queries and $255k follow up in real time for billing. In Identified Revenue

SITE C - PRIVATE, ACUTE HEALTH SERVICE Outcomes Case Mix: Complex, Tertiary Referral, Research and Teaching Hospital • Identified data and process issues impacting on revenue stream. Audit Sample: 200 / Also a Billing Audit • Incorrect critical care charges and Incorrect CMBS item numbers. $510k+ • Missed prostheses. In Potential Revenue due to discovered underbilling

SITE D - PRIVATE, ACUTE HEALTH SERVICE Outcomes Case Mix: Medium, Surgical, Medical • Coding errors resulting from lack of clinical documentation for high Audit Sample: 200 / Also a Billing Audit revenue speciality.

• Inaccurate ICU billing. Education given to ICU staff in completing $100k+ certificates. In Identified Revenue and overbilling • Risk of revenue repayments identified.

SITE E - PRIVATE, ACUTE HEALTH SERVICE Outcomes Case Mix: Medium, Surgical, Medical • Identified DRG change rate in high teens. Audit Sample: 200 (including 50 optimised records) / Also Billing Audit • Clinical Coders required education in private funding model.

• Identified delays in admission to cash process. Recommended $45k solutions. In Identified Revenue for 50 episodes

We Can Help You Meet Your Performance and Financial Goals [email protected] Contact us today to learn about our Coding Solutions and how we can help you. ozescribe.com.au 1 300 SCRIBE (727 423)

07/30/18