Avera Health

The Client

Avera Health is a regional health system based in Sioux Falls, S.D., comprising more than 300 locations in 100 communities throughout South Dakota, Minnesota, Iowa, Nebraska and North Dakota.[1] Avera serves a geographical footprint of more than 72,000 square miles and 86 counties, and a population of nearly 1 million.
As a fully integrated health system, Avera Health includes Avera Medical Group, which is composed of physicians and advanced practice providers who serve patients at nearly 200 secure locations[2] across the five-state region.

Business Situation:

Services provided to the client for Clinical Documentation Improvement (CDI) shall include identifying improvement opportunities for clinical documentation to include financial and operational alignment that reflects consistent provider documentation that is accurate, specific, legible, and timely. Additionally, support coding of medical records to their greatest level of specificity, including but not limited to a focus on primary as well as secondary diagnoses.

Specifications and Deliverables were required:

Scalability

Highly Educated Coding Workforce

Cost Saving

High Security, HIPAA Compliant

ICD-10 Experienced Coders

Accelerate Cash Flow

Lean Six Sigma Principles

Dedicated Team of Medical Coder

Global Coding Academy for Medical Coding Certification

Friendly, Customer-Oriented, US-Based Coding Company with Provider-Proven Results

Solution and benefits:

We have used our team of highly experienced medical coders those who understand ICD-9 and ICD-10 coding guidelines (as well as the coding platforms)—benefits coding managers in multiple ways. First, it enables them to support existing staff, reducing their workload. It also provides training, encouraging new professionals to join the field of medical coding.

Provided experienced healthcare professional with extensive medical knowledge and a clinical background that includes anatomy, physiology, disease process, and ICD-10 coding.

Outsourcing to our coders cost about half the price of the domestic coders Outsource coding is a cost savings strategy that will enable providers to incorporate a larger workforce to perform medical coding functions.

We have won the complete confidence of client in information security, HIPAA Compliance, and Disaster Recovery which is essential to coding managers and is necessary in order to enable their ability to outsource a portion of their services. We shared these concerns and have taken steps to assure a secure information environment. Our coding partner maintains process and security certification in ISO 9001 and ISO 27001 while also complying with SSAE 16 Type 2 standards as well as all HIPAA regulations.

Diskriter has assigned ICD-10-CM diagnosis and procedure codes, and/or ICD-10-CM diagnosis and ICD-10-PCS procedure codes as applicable for inpatient encounters, determined principal and secondary diagnoses, principal procedure, and DRG grouping options for inpatient accounts. Diskriter has several AHIMA approved ICD-10-CM/PCS trainers. Our trainers were responsible for training our staff (including the new staff). By the time our staff started working on a contract; they were already trained and know the coding specification very well. When they started coding it was very easy for our coders to meet the 97% accuracy standard. The Diskriter coders were audited monthly to ensure a benchmark coding quality standard of 97% accuracy is met. Diskriter completed two types of audit reviews. The representation review is a sample of records at random. The focused review is a selection of records from a list of pre-identified problem areas. These reviews were completed on inpatient and outpatient records.

Coding reviews were completed monthly and are completed by mid-month of the following month (ex. January audits completed by mid-February).