Billing & Coding
CloneSleuth uncovers data once hidden in your EMR system by allowing you to proactively search and find inaccuracies in patient billing, discovering errors where patients were over or undercharged for care. This new solution enables you to catch billing errors before an auditor does by tapping into the historical data of the source of documentation for billing – patient record notes. With CloneSleuth, you’ll have the ability to:
Ensure Implementation of New Billing Codes– Specific medical billing codes for services and procedures are often being updated and rewritten – sometimes providing higher reimbursement. CloneSleuth allows you to review clinician compliance to optimize your revenue.
Confirm Billing Code Accuracy – CloneSleuth uncovers clinician non-compliance for code entries. For example, often clinical personnel will enter G-codes into the billing system for all patients for claims where Medicare is the primary payer. If these G-codes are not properly applied, Medicare could reduce payments. In addition, if G-codes are included in non-Medicare claims, other payers will not recognize them as being legitimate. CloneSleuth uncovers these instances to ensure faster reimbursements.
Document Proof of Service Evidence– The ability to quickly search and find specific proof of service for patient care saves you time and effort in documenting what you need to counteract insurance denial of work performed.
Train and Educate Clinicians– Advanced sorting capability allows you to pinpoint billing and coding error by department and even individual clinician, giving your hospital the information you need to develop training and education programs. CloneSleuth also provides you the information you need to determine the ongoing effectiveness of these training programs.