Don’t Let Revenue Slip Away: Keep Level 4 Patients From Being Coded As Level 3!
Picture this: A medical director sits in a dimly lit office, surrounded by patient charts. With steady hands and keen eyes, he carefully reviews each chart to determine the level of complexity of each visit. He is aware that any missteps can cost his practice thousands of dollars and tarnish his reputation as a reliable medical director. This delicate balance between coding too low—risking revenue—and too high—risking non-compliance with regulations—is a difficult challenge that requires both skill and experience.
Unfortunately, that scenario is all too common in urgent care centers (UCCs) across the country. Many UCCs are not aware of the risks of incorrectly coding level 4 patients as level 3. This can lead to significant losses in annual practice revenue. Thankfully, this seemingly complex problem can be solved with one simple solution: ExdionACE. Let’s take a closer look at the issue of incorrectly coding level 4 patients and how ExdionACE can help to ensure accurate coding.
The Consequences Of Coding Level 4 Patients At A Level 3 Visit
At UCCs, patient visits are typically classified as either a level 3 or level 4 depending on the complexity of the visit. Level 3 visits are straightforward, while level 4 visits are more complex and require a higher degree of medical decision-making (MDM). Unfortunately, making the mistake of coding level 4 patients at a level 3 visit can be dire.
For example, physicians can miss out on further assessment and diagnosis that is necessary for proper care. Additionally, if the patient’s condition requires additional tests or treatments, these would not be reflected by using the lower-level code. This means the physician is not getting credit for all their work, and their practice is losing out on that revenue.
Another consequence of incorrectly coding a level 4 patient at a level 3 visit is that medical insurance companies may not cover the entire cost of the visit or reimburse for all services rendered. This can result in substantial financial losses for both the UCC and their patients, as they are not able to get full reimbursement for their work. Furthermore, if an insurer discovers a procedure or test was recommended but not completed because it wasn’t coded correctly, this can lead to even more lost revenue.
How ExdionACE Can Help Optimize Coding and Increase Revenues
Fortunately, there is a solution that can help UCCs avoid these problems and increase their revenue in the process. ExdionACE is a cutting-edge AI-powered platform that can optimize coding based on MDM guidelines and instantly increases revenue anywhere from 10% to 18% in many cases. In fact, one UCC reported an additional $250,000 in revenue after using ExdionACE!
The following charts are actual client metrics for a single center urgent care assessed in February 2023. ExdionACE identified an additional $250,000 in revenue.
ExdionACE delivers improved coding by optimizing E/M levelsbased on MDM guidelines.
ExdionACE delivers an instant revenue increase of 10% to 18% and more in many cases. Annual practice revenue stands to increase by over $250,000.
ExdionACE is also incredibly easy to use. It automates the process of coding and can be quickly integrated into any UCC’s existing workflow systems. Clinicians can access comprehensive metrics that allow them to review their cases and ensure they are properly coded according to MDM guidelines. In addition, it provides real-time feedback on coding decisions made by clinicians.
By utilizing ExdionACE, UCCs can be assured that their level 4 patients are not being coded at a lower level, so they can receive the reimbursement and revenues they deserve. With this comprehensive solution, UCCs can rest assured their coding is accurate and their practice’s revenues will increase.
Make The Right Coding Decisions With ExdionACE
ExdionACE is the perfect solution for urgent care centers looking to optimize their coding and increase their revenue. By utilizing this comprehensive AI-powered platform, clinicians can ensure they accurately code all patient visits and properly assess MDM guidelines.
The following charts are actual client metrics for a single cenThis will not only help to maximize their reimbursement but also ensure that patients are receiving the best care possible. With ExdionACE, UCCs can be confident they are always making the right coding decisions.
ter urgent care assessed in February 2023. ExdionACE identified an additional $250,000 in revenue.
Take the first step towards optimizing your coding and increasing revenue today! Click the link and see how ExdionACE can help improve your practice.
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