Healthcare Services

Revenue Cycle Management

Whether you represent a hospital, a physicians’ practice, or an aggregator, the ultimate challenge you face is to improve the financial effectiveness of both your business/billing office as well as your operations management processes. Currently, a number of factors converge to place enormous pressure on financial managers. These include lower reimbursement, Medicare and Medicaid funding cuts, increasing medical insurance premium costs, quality reporting measures, the increase in the uninsured population, margin shrinkage, new ICD-10 codes, an increasing demand for experienced and skilled resources, and the demand for revenue-cycle process improvements. Lapiz thoroughly understands the issues you face and can offer powerful and effective solutions!

Lapiz’s Revenue Cycle services provide improved operational results for our clients (who include providers, health systems, independent practices, aggregators, and medical billing and consulting companies). Our value-added services, such as those listed below, have helped our clients to maximize their revenue and improve their cash flow. The services that Lapiz provides are particularly valuable because they offer the dual benefit of saving both time and money.

  • Patient Demography
  • Charge Entry
  • Eligibility Verification
  • Coding and Reviews
  • Transmission Rejections and Management
  • Payment Posting (ERA and Manual)
  • EDI Setup
  • Fee Schedules/Charge Master Analysis
  • Workflow Management
  • Provider Contracts Management
  • Payment Audits and DRG Audits
  • AR Analysis and Follow up
  • Aged A/R Clean Up
  • Denials and Rejections

Medical Coding/HIM Services

It’s essential for healthcare providers to maximize their revenue in exchange for the services they provide. Complete and timely payment begins with quality coding.

Navigating the difficult environment of ever-changing government regulations, reimbursement rules, the vast array of medical codes, the increasing use of technology, and the shift from fee-for-service to value-based delivery and payment systems, is extremely challenging. Having access to experienced and credentialed coding professionals is critical to the sustainability and financial growth of your medical practice.

Lapiz’s Coding solutions are designed and focused on improving all aspects of HIM. Our team of AAPC- & AHIMA-credentialed coders review all encounters to ensure the complete and accurate capture of charges. This detailed approach results in optimal reimbursement, regulatory compliance, increased cash flow, reduced coding denials, benchmark accuracy, and faster turnaround times. Our comprehensive facility and professional coding, audit and CDI services cover every specialty area, both inpatient and outpatient services, in virtually any volume required.

Lapiz offers the following HIM/Coding services:

  • Remote Coding
  • Compliance Audit Services
  • Clinical Documentation Improvement
  • HIM Outsourcing
  • Clinical Abstraction
  • HCC/HEDIS Coding
  • Consulting

Specialties

Emergency Room Cardiothoracic Surgery Dental
Radiology Cardiology Rheumatology
Interventional Radiology Dermatology Neurosurgery
Anesthesiology Podiatry Urology
Pain Management Urgent Care Physiotherapy
General Surgery Gastroenterology Observations
Ambulatory Surgery Care Neurology Pediatrics
Internal Medicine Acute Care Trauma
Psychiatry Rehab Therapies Vascular
Radiation Therapy OB/GYN Hospitalists
Oncology Orthopedics Labs
Pathology Chiropractic Evaluation & Management Services
Pulmonology Nephrology Family Practice

HCC/Risk Adjustment Coding

Lapiz offers complete identification, verification, and retrieval of all chart-based diagnostic information related to HCC risk factor methodology. Our unique HCC coding process captures all appropriate information to ensure the accuracy of the diagnoses prior to submission to HHS, CMS, or state departments of health within the risk adjustment period. Our team has a solid understanding of nearly 87 HCC categories of chronic illnesses with thousands of diagnosis codes and can accurately map the codes in order to ensure proper reimbursement. Our goal is to help our clients extract all of the documentation for Medicare Audit compliance, which results in an improved RAF score for each member.

Lapiz offers:

  • Resource pool of experienced HCC coders
  • Comprehensive review of records from all sources
  • In-depth analysis of diagnostic codes
  • Coding according to the ICD-10 Guidelines for Coding and Reporting and assigned based on dates of service within the data collection period
  • Beneficiary HCCs and risk adjustment records are selected based on risk adjustment diagnoses (ICD-10)
  • Addressing the root cause of missed/suspect/embedded codes and reporting
  • Submitting to the MA organization from an appropriate risk adjustment provider type and an appropriate risk adjustment physician data source
  • Streamlined process for workload balancing

Payer Services

The U.S. healthcare industry is currently experiencing unprecedented regulatory and margin pressures. Tectonic changes, including the ACA, MU2, ACOs, and the ICD-10 migration, are motivating both providers and payers to search for ways to dramatically improve their internal productivity and efficiency while maintaining the quality of their services at a much lower cost.

The team at Lapiz can assist you with effective:

  • Claims Administration
  • Enrollment Processing
  • Authorization Linking
  • Adjudication Services
  • Claims Entry
  • Appeals and Grievances
  • Risk Adjustment Audit (HCC Coding)
  • HEDIS Abstraction
  • Mail Room Functions
  • Customer Support Services