Overview
Elevate your revenue cycle management with our comprehensive Mid-Revenue Cycle Services, designed to improve compliance, accuracy, and efficiency.
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Mid-Cycle Services
Clinical Documentation Improvement (CDI) Services
We offer expert CDI services, ensuring your organization benefits from onsite or remote support from vetted CDI professionals. Our ability to quickly scale staffing and provide comprehensive CDI management and practitioner documentation audits enhances your revenue cycle while ensuring compliance and improved patient care.
Services:
- CDI Management Interim Contract Staffing
- CDI Specialists Interim Contract Staffing
- CDI Audits
Key Features:
- Competitive Pricing
- Onsite or Remote Support
- Vetted CDI Professionals
- Ability to Quickly Scale
- Comprehensive Reports
- Competitive Pricing – Domestic, Offshore, or Hybrid
Patient Types:
- Inpatient
- Ambulatory Surgery Coding
- Emergency Department Coding
- All Outpatient Coding
Settings:
- Acute Care
- Critical Access
- Ambulatory Surgical Centers
- Medical Practices
Components:
- Physician Documentation
- Physician Assistant Documentation
- Nurse Practitioner Documentation
Medical Coding Services
We believe in delivering top-tier medical coding services with domestic, offshore, or hybrid models, ensuring tailored solutions for your organization. With rapid implementation in just two weeks, we offer 24-hour turnaround times and comprehensive coverage, including U.S. holiday support and embedded quality assurance, enabling efficient coding across all patient types and settings.
Services:
- Full or Partial Outsourced Coding Services
- Interim Coding Services
- On-Call Coding Services
- Backlog Coding Services
Key Features:
- ICD-10-CM, ICD-10-PCS, CPT/HCPCS
- MS-DRGs, APR-DRGs, AP-DRGs, APCs. HCCs
- Competitive Pricing – Domestic, Offshore, or Hybrid
- Ongoing Support
- 2 Week Implementation
- < 24Hour Turn-around
- Up to 7 Days Per Week of Service
- U.S. Holiday Coverage
- Embedded Quality Assurance
- Monthly Value Reports
Patient Types:
- Inpatient
- Ambulatory Surgery
- Emergency Department
- Ancillary Department
- Clinic
- All Outpatient
Settings:
- Acute Care Hospitals
- Critical Access
- Long Term Care
- Outpatient Settings
Components:
- Facility Component
- Professional Component
Comprehensive Outpatient Revenue Integrity Services (CORIS)
Our CORIS Service assist healthcare providers with proper compliance, keeping revenue integrity, and preventing costly errors. By applying this optional charge code validation service, facilities can safeguard their financial health and improve claim outcomes with precision coding.
Services:
3 Prong Approach -
- Coding
- Validation and Correction of Charges
- Documentation Review and Feedback
Key Features:
- Bringing CDM-driven Codes/Charges Together with the Coder-assigned Codes
- Correction of OCE/NCCI Edits Prior to Accounts going Through the Scrubber
- Includes Recommendations for Documentation Improvement
- Services Provided by Certified Coders Trained in Revenue Integrity
- Summary and Detailed Reports
- Mitigation of Denials
- Competitive Pricing – Domestic, Offshore, or Hybrid
Patient Types:
- All Outpatient
- Ambulatory Care Patients
- Inpatient
Settings:
- Hospitals
- Ambulatory Surgical Centers (ASCs)
- Physician Practices
- Specialty Clinics
- Emergency Departments (EDs)
Components:
- Facility Component
Data Quality Service
Maintaining accurate and compliant medical coding is key to proper reimbursement and less denials. With our Data Quality Service, healthcare providers can improve coding accuracy, identify areas in need of improvement, and assess the completeness of clinical documentation.
Services:
- Coding Audits
- DRG Validation
- Documentation Reviews
- Charge Validation
Key Features:
- Pre-Bill/Concurrent Audits
- Retrospective Audits
- Includes Revenue Opportunities and Compliance Recommendations
- Customizable Audit Scope
- Frequency Options (Daily, Weekly, Monthly, Quarterly, Annually)
- Summary and Executive Reports
- Comprehensive and Detailed Reports
- Trending Reports
- By Coder
- By Practitioner
- By Code Type
- By Error Category
- Competitive Pricing – Domestic, Offshore, or Hybrid
Patient Types:
- Inpatient
- Outpatient
- Ambulatory Surgery Patients
- Emergency Department (ED) Patients
- Long-Term Care Residents
Applicable Settings:
- Hospitals
- Ambulatory Surgical Centers (ASCs)
- Physician Practices
- Long-Term Care Facilities
- Emergency Departments (EDs)
Components:
- Facility Component
- Physician Component
Education Services
Our Education Services help to equip your team with the knowledge they need to navigate the complexities of healthcare and stay up to date with regulatory standards.
Services:
- Coding Education for Coders
- Documentation Education for Practitioners
- Compliance Education
- HIPAA Education
- Annual IPPS/OPPS Updates
Key Features:
- Tailored Training Programs
- Continuing Education Credits (CEUs)
- Live or Recorded Webinars
- Online Training (Onsite Available)
- In Line with Industry Standards
- Hands-On Learning Modules
- Certification Prep
- Ongoing Support
- Competitive Pricing – Domestic, Offshore, or Hybrid
Patient Types:
- Inpatient
- Outpatient
Applicable Settings:
- Hospitals
- Ambulatory Surgical Centers (ASCs)
- Physician Practices
- Specialty Clinics
- Emergency Departments (EDs)
Components:
- Facility Component
- Physician Component
Coder Mentoring Service
Building a team of proficient coders is paramount to the success of your healthcare organization. This hands-on approach improves coder’s skills and contributes to the overall quality of your coding operations.
Services:
- Mentoring of New Coders
- Mentoring of Coders Moving to a New Patient Type
- Mentoring of Seasoned Coders on Another Coding System
Key Features:
- ICD-10-CM, ICD-10-PCS, CPT/HCPCS
- Pre-Bill Support
- Use of Real Coded Medical Records
- Includes Instructional Lessons, if Needed
- Feedback to Coding Leaders
- Personalized/One-on-One Mentoring
- Customized Mentoring
- Continuous Skill Development
- Competitive Pricing – Domestic, Offshore, or Hybrid
Patient Types:
- Inpatient
- Outpatient
- Emergency Department (ED) Patients
- Ambulatory Surgery Patients
- Long-Term Care Residents
Applicable Settings:
- Hospitals
- Ambulatory Surgical Centers (ASCs)
- Physician Practices
- Long-Term Care Facilities
- Specialty Clinics
Components:
- Facility Component
- Physician Component
Edit Reconciliation Service
Choosing our Edit Reconciliation Service, healthcare providers can address their edits timely and completely to decrease the days in A/R, decrease the time and cost handling a claim multiple times, enable quicker claim turnaround. This leads to faster and more accurate reimbursement and a smooth and efficient revenue cycle.
Services:
- Comprehensive Edit Review
- Coding Error Correction
- Fast Claims Resubmission
- Clean-up of Outpatient Exception Report
- Consulting Services
Key Features:
- Expedites Claims Submission
- Compliance Assurance
- Customizable Solutions
- Competitive Pricing – Domestic, Offshore, or Hybrid
Patient Types:
- Inpatient
- Outpatient
- Emergency Department (ED) Patients
- Ambulatory Surgery Patients
Applicable Settings:
- Hospitals
- Ambulatory Surgical Centers (ASCs)
- Physician Practices
- Specialty Clinics
- Emergency Departments (EDs)
Components:
- Facility Component
Interim Management and Staffing
Our Interim Management and Staffing Service provides healthcare organizations with expert leadership and staff needed for continuity during times of transition. With experienced H.I.M. and Revenue Cycle professionals, we enable your organization to staff accordingly and never be left with a vacant position, especially in a leadership role.
Services:
- Health Information Management (H.I.M.) Interim Management and Staffing
- Patient Financial Services Interim Management and Staffing
- Business Office Interim Management and Staffing
- Patient Access Interim Management and Staffing
- Revenue Cycle Leadership Interim Management
Key Features:
- Interim (Short Term or Long-Term)
- Flexible Engagements
- Vetted Professionals
- Competitive Pricing
- Expert Leadership
- Process Optimization
- Compliance Oversight
- Training and Development
- Competitive Pricing – Domestic
Patient Types:
- Inpatients
- Outpatients
- Emergency Department (ED) Patients
- Ambulatory Surgery Patients
Applicable Settings:
- Hospitals
- Ambulatory Surgical Centers (ASCs)
- Physician Practices
- Specialty Clinics
- Long-Term Care Facilities
Components:
- Facility Component
- Physician Component
Other H.I.M. Services
Pena4 delivers tailored solutions increasing operational efficiency and ensuring compliance, backed by a team of experts committed to optimizing your health information management processes.
Services:
- Operational Assessments
- Health Record Analysis
- MPI Clean-ups
- DNFB Management/Clean-up
- Release of Information (ROI) Support
- Consulting
Key Features:
- Quick Implementation
- Scalable Solutions
- Customizable Service Packages
- Data Security
- Ongoing Support
- Competitive Pricing – Domestic
Patient Types:
- Inpatients
- Outpatients
- Emergency Department (ED) Patients
- Ambulatory Surgery Patients
Applicable Settings:
- Hospitals
- Ambulatory Surgical Centers (ASCs)
- Physician Practices
- Specialty Clinics
- Long-Term Care Facilities
Mid-Cycle Services - Why Pena4?
Our solutions help ensure compliance, reduce coding errors, and optimize reimbursement. By partnering with Pena4, healthcare providers can simplify mid-cycle processes, enhance data quality, and maximize revenue, all while maintaining industry standards and improving overall operational performance.
Ready to engage with our Mid-Cycle Services?
This is one of very few vendor relationships I have experienced in my 35 years as an HIM where I truly feel like we are partners with the same goal in mind-quality health information.
Cindy Penner
The Ottawa Hospital
I have had experience with other offshore coding services, and the quality from the Pena4 coders is excellent.
Craig Chase
Catholic Health Services
Very responsive team, expert knowledge, and easy to work with.
John Samuels
Better Health Advisors
Always on point with Turn Around Time requirements.
Lordy Josama
One Brooklyn Health System
Great long-term relationship, able and willing to meet our needs. Great customer service, great support, great outcomes!
Ray Cosner
Mt. Sinai Health System
It has been such a pleasure to work with Pena4 and their team. They have highly educated coders and I do not need to be involved in their internal processes, they know how to get the job done and with great quality.
Bonnie DiAntonio
RWJ Barnabas South
Pena4 continues to deliver high-quality services to our Team. We look forward to maintaining our strong partnership with the Pena4 Team.
Jade Johnson
Mount Sinai Hospital MSH/MSQ
Thank the management team, Arnab, Navin, Caroline, and the entire support team for their continued support and dedication to BronxCare Health Systems.
Valerie Oselmo
BronxCare Health System
Pena4 staff was helpful and accommodating to our professor and students' needs.
Dasantila Sherifi
Rutgers University
Implementation is a 2-way street and Pena4 keeps up its end. They provide great service with involved and attentive operations leaders.
Craig Chase
Catholic Health Services
Love the Team! Deb, Bernie, and Shelley are extremely knowledgeable, friendly, and especially pleasant to work with!
Sonia Shiels
Joseph Brant Hospital
We hired HIMonCall to assist with coding to meet our mandated fiscal year deadlines. We were able to meet this deadline successfully with the help of these contract coders and the work was delivered on time, as promised.