Our Analytics team can look deep into the data to provide unique insights and cost-saving opportunities for any organization.
Retroactive Auditing - Aggregate and Claim-level Identification of salient cost-saving opportunities Top chronic health conditions for the employee population Top providers cost/quality comparison and ranking Inpatient Clinical PharmacyA number of other companies in this field try to use Standard Analytical Files (SAF) data to position the organization within a certain quartile in comparison to other facilities in the country. However, that in itself is not a sound approach. Our methodology will use SAF data just as another data point which can help us with overall decision-making process but placing or trying to force-fit the organization in a given quartile is not the objective. Our goal is to simply assist the facility to code a level of service based on facility resource consumption. To that effect, CTech has the following process in place:
CTech has the framework and has developed an ED Calculator that can be used alongside any Enterprise EHR such as Epic® , Cerner® etc. The current version of CTech’s ED Calculator based on the number of activities identified by the coding and nursing staff has approximately 90 different activities (any number of activities can be defined, 60-90 range is typical) that have points associated with them. CTech will review these activities with facility’s coding and nursing staff to identify activities that they do not deem relevant and also incorporate other activities that they feel need to be included. CTech will also review with them points associated with each activity and adjust the points accordingly thereby making the solution customized based on the judgement of the facility’s coding and nursing staff. CTech would request about 300 cases that have already been coded to be coded through CTech’s ED Calculator and then compare the results of CTech’s ED Calculator with the actual E&M codes billed. At this point, CTech will compare the cost of overall services as described earlier and what adjustments are needed to align the cost of services to ED E&M reimbursement. During the initial year of implementation, CTech might do two quarterly reviews of how the overall E&M levels under the new methodology are compared with the 300 cases that were retroactively coded under our methodology and the Activity-based Calculator is adjusted as needed. Once the Calculator has been based on six months of activity, CTech can review the overall E&M levels on annual basis on account of the fact that our new estimation is based on a much larger sample.With this approach, CTech believes the facility can use a consistent methodology that is compliant, dependable and the cost of services that are reimbursed through E&M levels are in line with the E&M revenue.
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