Healthcare Services

Revenue Cycle Management

Be a Hospital, Physician Practice or an Aggregator – Improvement and changing your financial shape of your business/billing office and operations management is our goal. Factors such as lower reimbursement, medicare and medicaid funding cuts, increasing medical insurance premium costs, quality reporting measures, increase in uninsured population, margin shrinkage, new ICD 10 codes, an increasing demand for experienced and skilled resources, demand process improvements in the hospitals and physician practice’s revenue cycle.

Lapiz's Revenue cycle Services has provided improved operational results for our clients such as providers, health systems, independent practices, aggregators, medical billing and consulting companies. Our value-added services, such as those listed below have helped our clients to maximize their revenue and improve the cash flow. It's always a dual bonus for our clients to have saved Time and Cost.

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

Medical Coding-HIM Services

Its essential healthcare providers maximize their revenue for service rendered. Quality payment starts with quality coding.

In an environment of ever changing government regulations, reimbursement rules, ever-growing array of medical codes, increased use of technology, shift from fee-for-service to value-based delivery and payment systems, having access to experienced and credentialed coding professionals, it is critical for sustainability and financial growth.

Lapiz's Coding solutions are designed and focused on improving all aspects of HIM. Our team of AAPC & AHIMA credentialed coders reviews all encounters to ensure complete and accurate charge capture. Thus, resulting in an optimal reimbursement, regulatory compliance, increased cash flow, reduced coding denials, benchmark accuracy, and turnaround times. Our comprehensive facility and pro fee coding, audit and CDI services cover every specialty, inpatient and outpatient, and virtually any volume needs.

Lapiz offers the following HIM/Coding services:

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

Specialities

Emergency Room Cardiothoracic Surgery Dental
Radiology Cardiology Rheumatology
Interventional Radiology Dermatology Neurosurgery
Anaesthesiology 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 Orthopaedics Labs
Pathology Chiropractic Evaluation & Management Services
Pulmonology Nephrology Family Practice

HCC/Risk Adjustment Coding

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

  • Resource pool of experienced HCC coders
  • Review records from all sources
  • In-depth analysis of diagnostic codes
  • Coded 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
  • Submitted to the MA organization from an appropriate risk adjustment provider type and an appropriate risk adjustment physician data source
  • Streamlined process to balance the workload

Payer Services

We are witnessing an unprecedented regulatory and margin pressures in the US healthcare ecosystem. Tectonic changes, including the ACA, MU2, ACOs, and the I-10 migration, are motivating both Providers and Payers to look at ways to dramatically improve their internal productivity and efficiency, while maintaining the quality of their services –at a much lower cost base.

Lapiz can assist you with effective:

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