Healthcare Payment Specialists expands RCM offerings: 5 things to know

Healthcare Payment Specialists have recently launched two revenue cycle management products: Uncompensated Care Analytics and Complex DRG Review.

Here are five things to know about the products.

Uncompensated Care Analytics

1. The UCA solution aims to help hospitals in completion of Worksheet S-10, one of the worksheets contained in the Medicare Cost Report. CMS expects to implement Worksheet S-10 as part of the uncompensated care calculation for the Medicare Disproportionate Share Hospital formula by fiscal year 2021.

2. Specifically, the UCA solution aims to help hospitals complete Worksheet S-10 completely and accurately and to provide the full documentation needed for audit, HPS said.

3. Using the UCA solution, HPS works with hospitals to collect the data required to complete Worksheet S-10 and subsequently applies the resources and expertise to aggregate and analyze the data consistent with the instructions of Worksheet S-10. HPS said it then presents the hospitals with the information needed to complete Worksheet S-10, the documentation needed for audit and additional analytics for benchmarking and reimbursement impact analysis.

Complex DRG Review

4. The Complex DRG Review solution helps hospitals identify and re-file Medicare claims where the medical record clearly supports the assignment of a higher paying diagnosis-related group code, according to HPS.

5. Through the Complex DRG Review solution, HPS identifies claims with a high probability of being undercoded. These claims are then independently reviewed by medical coders, and claims that have a supportable case for a higher paying DRG assignment are re-filed in the Medicare Direct Data Entry system.



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