Wellington, FL -- (SBWIRE) -- 11/19/2012 -- After its many years of comprehensive audit activity on medical billing, coding, clinical documentation and denial management in Hospitals, free standing ambulatory care centers and physician practices; Health Systems Management is pleased to announce that it is taking on clients to perform medical billing and medical coding.

Many clients have asked HSMN to step in and help with their coding and billing needs. HSMN likens this to the excellent prosecutor who becomes a superb defense counsel. The analogy was made by the HSMN’s President, Cathy Idema, when she recently addressed a group of CFO’s who wanted to know “how do you get it right the first time”? Cathy’s answer was “hire us and we will show you.” The medical coding and billing group has been formed under Mary Lou Laughner, RHIT, CCS-P, CPC, CPC-H. Mary Lou serves as the head of auditing and education for HSMN. For many clients, she has helped to put into place retrained staff with the proper credentials and the one ingredient so often missing: “Critical Thinking Skills”.

HSMN’s Coding and Billing Group (CBG) will help assess current staff skills, reengineer work flows and work queues and work with medical staff on clinical documentation concerns. The CBG group will work on current coding and billing as well as help clear up backlogs and review claims that have been denied.

The true measure of success with medical coding and billing is that over a 26 year period, our clients have not only stayed out of compliance mayhem but have also done well financially because of the care, concern and due diligence that each of the team members bring. Organizations under OIG scrutiny have engaged us and we have worked to assure that all requirements are not only satisfied but that after we leave there is a very high quotient of integrity and skill in the medical coding and billing processes.

The Centers for Medicare and Medicaid Services (CMS) has only begun to come down on the physician billing and hospital billing. New systems which give physicians choices about what they have done in the encounter, have also opened the door for fraud and abuse. Health Systems Management Network works under the principle that if it is not documented, it did not happen. That is the major reason HSMN works with the medical staff and have always been successful.

When engaged, a thorough analysis is completed of all of the coding on both the hospital and physician sides. We look at trends to discover who on the staff may have a pattern that suggests a lack of knowledge in securing the appropriate level of assignment. These analyses help to focus on those who need the most support; the staff is identified and the HSMN team rounds with them to see how they arrive at their assignments of codes. So often, it is found that many physicians are under coding because they fear scrutiny not understanding that under assignment is as much a concern as ever.

Call HSMN at 866-908-4226 to learn more about what the CBG group does for its clients.