Technology and Process Knowledge

Develop Innovative Solutions

An academic hospital system from the East Coast was struggling with their oncology, infusion and interventional radiology (IR) medical coding management. Their incumbent coding vendor had been delivering poor quality and was failing to manage case volume.

The group that had acquired the hospital system placed a high emphasis on running lean and efficient operations. As part of a cost-saving initiative, oncology and IR medical coding functions were quickly outsourced. This change created various issues. Between poorly coordinated multi-system involvement and inadequate due diligence, management began to seek alternate solutions.

Additional concerns existed for the client, as well. Without good systems in place, reconciling charts and managing cases with missing information was problematic. With a weak reporting system, important details fell through the cracks. The poor quality of existing systems and the resulting billing delays significantly reduced revenue. Additionally, there was no transparency in the invoicing process.

Vee Healthtek analyzed the hospital system’s concerns and provided optimal solutions. A new technology solution using a proprietary coding workflow platform called MCode was introduced. After applying the solutions created by Vee Healthtek, the overall quality and timeliness of the client’s coding processes improved. This enabled the hospital system to address exiting issues related to transparency, reconciliation, monitoring, reporting, and invoicing concerns.

The client sought a partner with coding abilities who could bring value to the table with the resolution of problems. Vee Healthtek was in the right place at the right time to intervene, and provided a proposal to perform oncology and intervention radiology coding with the following list of innovative solutions to address the client’s needs and streamline the entire process, summarized below:

Technology and Process Knowledge
Concern Category Summarized Client Issues Solutions Provided by Vee Healthtek
Coding Quality and Compliance The incumbent vendor struggled to manage coding quality and compliance related to complex oncology and IR coding.
  • Deployed a team of experienced certified coders
  • Performed sample audits on previous vendor’s chart coding, identified discrepancies and highlighted areas for improvement
  • Quickly improved work quality from day one
  • Provided an ongoing quality and feedback program with certified auditors
  • Collaborated with hospital compliance team to ensure accurate implementation of internal policies
  • Educated providers to improve documentation
Managing Volume & Turnaround Time (TAT) Lack of adequate workflow processes resulted in an inability to keep up with volume, delayed billing and lead to a loss in revenue
  • Conducted initial due diligence of current workflow and provided volume estimation
  • Implemented MCode platform to manage workflow
  • Ramped-up within three weeks from go live to manage daily volumes
  • Completed chart reviews within 36 hours for those received
  • Utilized MCode monitoring and control modules to ensure no charts or accounts were skipped or lost in transition
Reconciliation Issues Hospital use of multiple systems for scheduling and billing with a lack of coordination resulted in delays of timely system updates and caused slowed closing of queries
  • Worked with front desk team to flag/click confirmed patient schedules in the system
  • Confirmed patient schedules were imported from client system to MCode, based on flag/indicators
  • Imported and populated data in MCode for coders to update status
  • Provided “End of the Day” report with exact status of each patient seen at hospitals
  • Granted access to efficiently run cumulative status reports for a given periods
  • Automated system-generated email reminders for pending or outstanding items
  • Conducted random sample audits of the entire workflow to ensure uniformity
Management of “Pending for Information” Cases Manual record keeping of cases requiring additional information to process (“Pended for Information”) prevented consistent and accurate tracking, causing further delays in billing and losses in revenue
  • Created a standard list of pending reason codes in MCode
  • Upon completion of coding, coders updated chart statuses (Completed, Pending for Information, Report Incomplete, etc.)
  • Added free text to allow for the inclusion of additional information
  • Enabled client to access MCode application remotely to review and resolve questions
  • MCode allowed the client to send notes to coders to suggest resolutions
Report and Dashboards Between the hospital system’s limited reporting features and the incumbent vendor’s inability to supply more than a standard production report, trends and feedback were not being shared with the providers
  • Provided the ability to run reports by specific provider or criteria
  • Created reports by specific rules sent to respective doctor offices to save time
  • Ensured a secured, accurate, and seamless transmission of information
  • Created a real-time MCode dashboard and report access
  • Provided robust monitoring and transparency through MCode report modules
  • Allowed users, clients, and providers to create customizable quality metrics
  • Provided consistent feedback mechanisms through MCode to adhere to coding guidelines
  • Created a robust Clinical Data Improvement (CDI) program and supplied provider feedback

Additionally, the enclosed graph provides further details related to the work Vee Healthtek performed, listed below:

  • AWS - Secured Cloud Environment
  • Compliance Infrastructure
  • Encryption In-Transit and At-Rest
  • Virtual Desktop Access
  • Customizable Workflow
  • Quality Assurance
  • Scaling Capabilities
  • Customized Dashboards
  • RPA Integration
  • Analytical Reporting
Technology and Process Knowledge - Graph

Vee Healthtek positioned with this client to provide enterprise-wide coding services. Technology solutions, in conjunction with experienced and skilled medical coders, was appreciated by the client’s executive team. Vee Healthtek is committed to building an organized approach, adapting its capabilities to meet the client’s needs by establishing accountability and outcome-driven results to create the perfect setting for a successful partnership.


Meet the Author

Roopesh Shetty - Assistant Vice President Operations and Sales

Roopesh Shetty has been with Vee Healthtek since 2012. He has over 18 years of experience in managing RCM services for some of the most reputed academic, community hospitals and billing companies in America. His background in operations and client service provides the leverage to understand, articulate, and provide an optimal solution. He is extensively involved in onboarding, implementation, and account management for most of our prominent clients. Roopesh has a Bachelor’s degree in Accounting and Business Management and is an MBA candidate at University of Illinois.