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2014
Xertz Business solutions Pvt Ltd
10/23/2014
Xertz Service Capabilities
Table of Contents
1. About Xertz...........................................................................................................................................3
2. Why Xertz?............................................................................................................................................3
3. Service snapshot...................................................................................................................................4
4. Physician coding services.....................................................................................................................4
5. Hospital coding services.......................................................................................................................5
6. Other coding services...........................................................................................................................5
6.1 HCC coding....................................................................................................................................5
6.2 HEDIS Review................................................................................................................................6
7. Client Systems Expertise ......................................................................................................................7
8. Contact us.................................................................................................................................................7
1. About Xertz
XERTZ – a Healthcare services organization dedicated to serve the need of Healthcare Industries
through committed and reliable services.
Our “right” skilled resources, enhanced process, excellent quality and turnaround time helps us
to deliver the best services to our clients and differentiates us in healthcare industry.
XERTZ is committed to provide better career for the Healthcare Professionals and empathetic
service to our customers.
2. Why Xertz?
Xertz Management team has over 15+ years of experience in healthcare services and has served
clients in various specialties and scopes.
 Better understanding of scopes and services
 Alignment of process towards client needs
 Cost effective operational model
 Open communication and customer engagement
 Process control and best work flow
 Performance tracking and continuous improvement
3. Service snapshot
4. Physician coding services
Seasoned coding professionals with hands on experience in various physician coding specialties
which includes but not limited to Radiology, Pathology, Emergency room, Surgery, Anesthesia, Pain
management, Internal medicine, Neurology and cardiology provides coding support for our clients
of physician groups
Process flow – Physician coding
PhysicianCoding
•Radiology
•Pathology
•ED
•Surgery
•Anesthesia
•Pain Management
• Internal Medicine
•Neurology
•Cardiology
HospitalCoding
• Inpatient DRG
•Same day surgery
•ED
•Clinics
•Ancillary &
diagnostics
OtherCodingServices
•HCC coding
•HEDIS review
Medical Records
- Client system or
SFTP
Code Assignments
- Billing system
- Coding interface
Quality check
- By designated QC
- Sample size to be determined
based on quality trends
Output
- Export / abstraction of codes
-Coding information in desired
format
-Documentation deficiencies
shared for provider education
5. Hospital coding services
Facility / Hospital coding professionals with good experience in various work types including but not
limited to Inpatient – DRG coding, Same day surgery, Clinics, Emergency room and Ancillary /
Diagnostic coding provides coding services in various hospital systems.
Process flow - Hospital coding
6. Other coding services
6.1 HCC coding
Hierarchical condition category coding being complex in nature and requires very good
clinical knowledge and multi specialty exposure for accurate reporting of HCC codes. Our
team of HCC coders has 2+ years of experience in HCC coding for different Medicare plans.
Medical Records
- Hospital document management
system
Code Assignments
- 3M encoder
- Billing system
Quality check
- By designated QC
- Sample size to be determined
based on quality trends
Output
- Abstraction of codes
- Printing coding summaries
Process flow – HCC coding
6.2 HEDIS Review
HEDIS review of clinical measures is performed by abstractors who are basically paramedical
and life science graduates with good clinical knowledge. In addition, they are trained in Medical
coding guidelines as well which helps them to abstract the clinical information from medical
records accurately.
Process flow – HEDIS Review
Medical Records
- Retrieval for reporting period
- For all members of the plan
Workflow
- Batched and scanned to client
system
HCC Assignments
- Review of medical record for
reporting period
- Captures appropriate HCC code
Output
- HCC codes submitted to CMS by
Plans for RAC audits
Medical Records
- Scanned and loaded to client
system
Process
- Coder / abstractor reviews
medical records
- Abstract relevant information
applicable for measure
Output
- Report whether the measure
has passed with required details
7. Client Systems Expertise
Our coders & Leaders have experience in various coding interfaces and billing systems. The
below list includes the different platforms that our staff worked so far…
Coding / Billing systems
RDX HMS
Citrix Cerner
Powerchart Mckesson
EPIC A-Life
Onbase Medsuite
HPF Meditech
HDM TES
3M Centricity
8. Contact us
Xertz Business Solutions Pvt LTD
No: 107 B, LDG Road
Little Mount
Saidapet
Chennai-600015
India No: 044-65623575, 044–65557787
US No: 1-239-344-7857, 1-215-240-8300
Email id: customer.support@xertzsolutions.com
www.xertzsolutions.com

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Medical Coding Capablities

  • 1. 2014 Xertz Business solutions Pvt Ltd 10/23/2014 Xertz Service Capabilities
  • 2. Table of Contents 1. About Xertz...........................................................................................................................................3 2. Why Xertz?............................................................................................................................................3 3. Service snapshot...................................................................................................................................4 4. Physician coding services.....................................................................................................................4 5. Hospital coding services.......................................................................................................................5 6. Other coding services...........................................................................................................................5 6.1 HCC coding....................................................................................................................................5 6.2 HEDIS Review................................................................................................................................6 7. Client Systems Expertise ......................................................................................................................7 8. Contact us.................................................................................................................................................7
  • 3. 1. About Xertz XERTZ – a Healthcare services organization dedicated to serve the need of Healthcare Industries through committed and reliable services. Our “right” skilled resources, enhanced process, excellent quality and turnaround time helps us to deliver the best services to our clients and differentiates us in healthcare industry. XERTZ is committed to provide better career for the Healthcare Professionals and empathetic service to our customers. 2. Why Xertz? Xertz Management team has over 15+ years of experience in healthcare services and has served clients in various specialties and scopes.  Better understanding of scopes and services  Alignment of process towards client needs  Cost effective operational model  Open communication and customer engagement  Process control and best work flow  Performance tracking and continuous improvement
  • 4. 3. Service snapshot 4. Physician coding services Seasoned coding professionals with hands on experience in various physician coding specialties which includes but not limited to Radiology, Pathology, Emergency room, Surgery, Anesthesia, Pain management, Internal medicine, Neurology and cardiology provides coding support for our clients of physician groups Process flow – Physician coding PhysicianCoding •Radiology •Pathology •ED •Surgery •Anesthesia •Pain Management • Internal Medicine •Neurology •Cardiology HospitalCoding • Inpatient DRG •Same day surgery •ED •Clinics •Ancillary & diagnostics OtherCodingServices •HCC coding •HEDIS review Medical Records - Client system or SFTP Code Assignments - Billing system - Coding interface Quality check - By designated QC - Sample size to be determined based on quality trends Output - Export / abstraction of codes -Coding information in desired format -Documentation deficiencies shared for provider education
  • 5. 5. Hospital coding services Facility / Hospital coding professionals with good experience in various work types including but not limited to Inpatient – DRG coding, Same day surgery, Clinics, Emergency room and Ancillary / Diagnostic coding provides coding services in various hospital systems. Process flow - Hospital coding 6. Other coding services 6.1 HCC coding Hierarchical condition category coding being complex in nature and requires very good clinical knowledge and multi specialty exposure for accurate reporting of HCC codes. Our team of HCC coders has 2+ years of experience in HCC coding for different Medicare plans. Medical Records - Hospital document management system Code Assignments - 3M encoder - Billing system Quality check - By designated QC - Sample size to be determined based on quality trends Output - Abstraction of codes - Printing coding summaries
  • 6. Process flow – HCC coding 6.2 HEDIS Review HEDIS review of clinical measures is performed by abstractors who are basically paramedical and life science graduates with good clinical knowledge. In addition, they are trained in Medical coding guidelines as well which helps them to abstract the clinical information from medical records accurately. Process flow – HEDIS Review Medical Records - Retrieval for reporting period - For all members of the plan Workflow - Batched and scanned to client system HCC Assignments - Review of medical record for reporting period - Captures appropriate HCC code Output - HCC codes submitted to CMS by Plans for RAC audits Medical Records - Scanned and loaded to client system Process - Coder / abstractor reviews medical records - Abstract relevant information applicable for measure Output - Report whether the measure has passed with required details
  • 7. 7. Client Systems Expertise Our coders & Leaders have experience in various coding interfaces and billing systems. The below list includes the different platforms that our staff worked so far… Coding / Billing systems RDX HMS Citrix Cerner Powerchart Mckesson EPIC A-Life Onbase Medsuite HPF Meditech HDM TES 3M Centricity 8. Contact us Xertz Business Solutions Pvt LTD No: 107 B, LDG Road Little Mount Saidapet Chennai-600015 India No: 044-65623575, 044–65557787 US No: 1-239-344-7857, 1-215-240-8300 Email id: customer.support@xertzsolutions.com www.xertzsolutions.com