{"content":[{"text":"Introduction \n Revenue Cycle Management is a term often tossed around. This paper gets down to the \n details regarding: Improving revenue and getting paid for the services you perform, \n including the complexity of patients managed.","bbox":{"left":0.058824,"top":0.03597,"width":0.865906,"height":0.11455399999999999}},{"text":"With the RevAssurant and Exafluence team, every party—from the Plan to individual \n providers—can improve patient care and increase revenue. \n Mission: Health Plans, MSOs, ACOs, and many other entities paid on risk, must properly \n document and code each and all conditions of the patients seen. The documentation and \n code must match the risk. Over coding or under documentation can result in severe \n recoveries and penalties from the government. Under coding can result in money left on \n the table. The at-risk entity must be careful to avoid either of the above and find a proper \n and accurate balance. \n The Simple Truth: The end coder and documenter, the physician practice, may not have \n the same risk incentives as the at-risk entity. In fact, sometimes the physician \n (documenter) and staff (coder) may have no risk at all. \n Challenge 1: Address all the conditions and illnesses a patient has, not necessarily all in \n one visit, and not necessarily in each visit. How can the provider, with dozens of patients \n per day ensure that the patient gets all relevant conditions addressed? \n Challenge 2: Ensure that the conditions addressed are done so in a fashion that justifies \n coding for them. Did the management, evaluation assessment, and treatment meet the \n appropriate criteria? \n Challenge 3: Document properly: Unfortunately, many EMRs were built when CPT coding \n (E&M and procedures) dominated the reimbursement landscape. Today, at-risk entities \n rely in ICD-10 coding. How does one bridge that gap? \n Challenge 4: Properly coding the documentation: WHEN should the doctor be queried \n about services that were provided but not properly documented?","bbox":{"left":0.058824,"top":0.168646,"width":0.865835,"height":0.526942}}],"images_bbox":[{"left":0.000082,"top":0.741856,"width":1.0,"height":0.340909},{"left":0.891013,"top":0.009343,"width":0.096895,"height":0.037058}],"images_bbox_not_text_overlap":[{"left":0.000082,"top":0.741856,"width":1.0,"height":0.340909},{"left":0.891013,"top":0.009343,"width":0.096895,"height":0.037058}]}