Coding Validation Services

Jzanus Consulting helps to ensure the accuracy of codes and DRG assignments that are submitted to third party payers in order to maintain compliance with federal and state guidelines for coding and billing purposes.  We assist hospitals with obtaining the highest appropriate recognition for the care and severity of illness to which it is entitled.  Jzanus’ proven approach is designed to capture all instances where improved coding affects DRG assignment and severity scores.

HIM ServicesOur HIM professionals providing coding reviews are all (RHIA, RHIT or CCS) and average twenty years of coding experience.  These highly experienced individuals have expertise in both the compliance and the financial ramifications of coding and work extensively with APR DRG’s across our large customer base in New York State.   Each has a deep rooted knowledge of coding, clinical disease processes, DRG grouping methodology and physician documentation requirements assuring our customers of an accurate and reliable audit.

Validation reviews can be conducted either onsite or on a remote basis on a prebilling or post billing basis. We can provide 24-hour turnaround of all referred records seven days a week.

Benefits of Jzanus services:

  • An independent third party audit process to ensure accurate coding and appropriate reimbursement.
  • Clinical documentation review for professional fees, patient acuity and severity levels.
  • Necessary documentation for appeal preparation.
  • A mechanism for identifying insufficient or inconclusive documentation for actual changes in the Case Mix Index.
  • Recommendations for coders based upon cases audited for improvement of coding and documentation.
  • Comprehensive reviews to ensure that all appropriate codes are captured to ensure the highest quality and SOI measurements are achieved.