RCX Payer Services

RCX's Clinical, DRG, Coding validation and education services ensures every diagnosis:
‍
• Meets established and best practice criteria
• Is supported by clinical documentation in the record

DRG Denial / Appeal Management

RCX  reviews claims for accuracy and integrity by ensuring clinical documentation support codes and DRG assigned and presented on payer claims.

Physician / CDIS / Coder / DRG Validator Education Services

RCX reviews a statistically significant sample of clients’ cases, identifies adverse patterns or issues impacting revenue and CMI, and customize in-service education for the appropriate staff. This assures a relatively quick measurable return on investment.

RCX trains your staff (providers, CDIs, coders) to capture the totality, completeness, and accuracy of the patient’s clinical picture.This attracts the optimum reimbursement appropriate for the complexity of each encounter.

Payer Services

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Clinical, DRG & Coding Validation Services

Provider Services

RCX Provides two modalities

  • Concurrent (pre-billing)

  • Retrospective (Post-billing)

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Clinical Documentation Integrity (CDI) Program Modalities

Implementation and Onboarding

For clients interested in implementing a CDI program, RCX can perform the initial evaluation, design a program that fits the client’s environment, create, assist in recruiting and training of the staff and monitor the program continuously for 3-6 months, then conduct periodic semi annual audits of the program as needed.

Retraining of specialist to get certified

RCX certified CDIP and trainers prepare the CDIS staff to successfully take the AHIMA or ACDIS CDI Specialist examination.

RCX as your CDI Program

RCX CDI program staffed by RCX staff to conduct provider education and effectively conduct the clinical documentation improvement independently or in combination with DRG validation services.

Physician / CDIS / Coder / DRG Validator Education Services

RCX reviews a statistically significant sample of clients’ cases, identifies adverse patterns or issues impacting revenue and CMI, and customize in-service education for the appropriate staff. This assures a relatively quick measurable return on investment.

RCX trains your staff (providers, CDIs, coders) to capture the totality, completeness, and accuracy of the patient’s clinical picture.This attracts the optimum reimbursement appropriate for the complexity of each encounter.

DRG Denial / Appeal Management

RCX  reviews claims for accuracy and integrity by ensuring clinical documentation support codes and DRG assigned and presented on payer claims.

RevCycle Xperts

Q-1
Does the return on investment (ROI) for your facility’s CDI / Coding / DRG Integrity services meet your expectation?
Q-2
Is your current Revenue Cycle Integrity Vendor effective in educating your Coding / DRG and Medical staff?
Q-3
Is your CMI reflective of the complexity of your cases or meet your projections?
Q-4
How about your DRG Denial /Appeal Management efforts?

For enquiries, contact us

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RevCycle Xperts

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