LexiCode Coding & Reimbursement Synchronization

Coding & Reimbursement in Sychronization

Incorrect coding as applied to contractual reimbursement methodologies often results in overpaid claims

Exela’s proactive measures maximize cash, reduce rework and enhance provider and member satisfaction. Call us to discuss how we may help you Get It Right The First Time, All The Time.

Exela Process:

1. Receive Claim Data: 837 claim data
2. Evaluate key coding risk areas: Medical Conditions & Coding Guidelines
3. Review Third Party Payer Agreements: Calculate Financial Impact of coding correction
4. Request Medical Record as Required: Documentation Review
5. Analyze Inpatient Claims: DRG impact & Reimbursement impact
6. Analyze Outpatient Claims: Procedure coding & Reimbursement impact
7. Flag future occurrences: Prior to payment to prevent errors
8. Request Provider correct “Prior To” claim submission: Future systemic improper coding
9. Calculate Net Financial Impact: Initial Payment vs. New Payment due to coding correction