Our Services

The ConsultCare Method
Care, Compliance, Profitability

Based on a proprietary formula for drilling down into CMS published data, ConsultCare Partners interprets the results and develops specific, actionable information for individual hospitals to follow.

The ConsultCare Method is a “street tested” (trench tested, field tested) approach. Hospital profitability and long term sustainability is tied directly to patient care and to compliance.

1) We address issues that impact "report cards" and payer profiles. Our recommendations are Medicare compliant, and never “bend” the rules. They are clinically appropriate and meet all payer guidelines.

2) Then we follow up by educating physicians and coders about the proper documentation and coding to reflect your cardiovascular patient population. Because physicians often do not understand the rules of coding and use language that cannot be clearly reflected in the ICD9 nomenclature, missed or inaccurate coding can be the result. Education can clear up these critical errors.

3) We outline data driven areas to focus on: Hospitals, coders and physicians worry about obeying billing and coding rules and fear accusations of upcoding. Clearly laying out the ground rules will alleviate many of the potential problem areas – and based on your hospital’s code history, we tailor results that should matter most to you.

• Review of cardiovascular chargemaster
• Assessment of cardiac case mix index and DRG distribution
• Assessment of outpatient billing and coding
• Audit of charts to determine issues related to coding and documentation
• Audit of billing to assure accuracy
• Customized education for your coders specific to cardiac and vascular
• Customized education for your physicians specific to cardiac and vascular
• Physician profiles related to casemix and diagnoses
• Assistance with improvement of severity scores and or payor report cards
• Development of concurrent coding model
• Development of ongoing physician education/query process

Cardiovascular coding is so complex, even talented seasoned coders miss the nuances and unknowingly leave thousands of dollars per case on the table.