1. UIIP/ UITP/ CIIP/ CINB/ CITP/ OIIP/
OITP Patients
IDX
(ADT)
System:
Productivity
Stats
(CPT Codes)
Ancillaries:
Pathnet, Radnet
(CPT Codes)
Coding
3M Diagnosis
ICD-9/ ICD-10/
DRG grouped
Information
correct and coded
correctly?
Hold Bills
(IDX)
SSI scrubbed
(Payor
specifications
met)
Claim Sent
Manual
Reviews
(HPA/ UR
review)
yes
No
Cerner EMR
(CDI concurrently
checking DRG,
Query physician)
Outbound ADT
CPT Codes
Outbound ADT
ICD 9&10 Codes
Claim Compiled
(IDX)
IDX and 3M
make edits and
scrub claim.
Insurance
Reviews Claim
Green = Cerner system
Red = 3M/ Diagnosis coding
Blue = IDX
Yellow = SSI
Denials
Charges
(handled by
Chargemaster,
seperated by
department
Write- Offs
Claim
Accepted?
WE GET PAID!!!