Pena4’s Consulting services division consists of certified HIM professionals with varied healthcare settings, including acute care facilities, ambulatory clinics and specialty hospitals.
A Clear Perspective
The transition to ICD-10 brought a new era of codes, guidelines and regulatory agency requirements. Keeping ahead of this changing landscape can be an overwhelming task. Pena4 professionals bring a fresh, informed perspective to HIM, coding and revenue cycle operations. We’re an important catalyst to help achieve key performance indicators and organization-wide goals.
Our team of HIM executives has an average of more than 20 years of hands-on HIM experience with specific focus on operations and interim management, revenue cycle, coding and auditing. We’ve been providing support to healthcare organizations throughout the United States and Puerto Rico for decades, with recent expansion into Canada.
Some of our HIM Consulting Services include:
Kick-off Meeting: Onsite event to determine the most cost-efficient, impactful audit scope and methodology.
Target Selection: Identify specific focus for each audit or review including high-risk diagnosis and DRGs, principal diagnosis, principal procedure, and specific CC or MCC conditions.
Validation Review: Complete validation of all diagnosis code assignments, procedure codes, sequencing and code specificity to ensure compliance with correct coding rules and latest guidelines. Validation (retrospective or concurrent) of all DRG (MS/APR) assignments is also provided.
Opportunity Improvement Report: Define all documentation improvement and coder education opportunities including a comprehensive report of all findings and recommendations.
Customized Education: Education and training program options are also available to address specific coder knowledge gaps and clinical documentation insufficiencies identified throughout the project.
Other Services Include:
- Facility and Professional Coding Services in the Outpatient Setting
- Inpatient Coding Services
- On-site or Remote Coder Mentoring
- Insurance Denials Management and Appeals
- DRG Validation / Physician Documentation / Charge Capture Audits and Recommendations
- HCC Coding and Auditing / Physician Documentation Improvement Recommendations
- Education Services
- H.I.M. Department or Coding Interim Management
- H.I.M. Department Operational Assessment
- MPI Clean-up Services
- Cancer Registry Abstracting Services
- Trauma Registry Abstracting Services
- Medical Record Scanning for all patient settings
Benefits of Choosing Pena4
Unparalleled team of HIM consultants: most possess multiple credentials and degrees
Varied experiences: informed insights from hundreds of hospitals, health systems and provider organizations
Onsight and remote consultations: no additional space required
Flexible scheduling: one time project, interim or long term