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MediRevv Slashes Backlog of Medical Coding-Related Denials with Ease and Speed at Northwestern Medical Group

Like most coding operations, Northwestern Medical Group’s (NMG) coders were never short of tasks to tackle. Front end production coding and edit resolution often took priority over working denials. Before long, they faced a sizable denials backlog they knew they needed to stomp out.
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What our clients are saying
This used to be one of the things that kept me up at night. I truly appreciate the work that has been completed over 6 months to reduce the inventory in these work queues from a high of $7.7M to the current amount of ~$40k.

Brad Cox

Director, Patient Accounting, Physician Services at NMG

The Solution

NMG had already determined the goals for this backlog project, and we wholly agreed. They couldn’t have been more clear or straightforward:
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Work through the coding denial backlog as quickly as possible.

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Identify trends to eliminate edit denials and provide education opportunities.

We carefully analyzed volumes, then hand-selected each coder for the NMG coding denials project. We tapped our strong, proven processes to train and ramp up our coders to work in NMG’s system and serve as an extension of their internal coding team. In doing so, we quickly set the stage to achieve—and surpass—the established goals.

 

Finding flexibility and value

The project began with four full-time coders who focused solely on the task of catching up on over 12,000 coding-related denials. Over time, five additional coders were added to work down the backlog. Having the right number of coders available offered NMG previously unattainable flexibility. While our team slashed through the denials backlog, NMG kept their own team focused on production coding, thereby avoiding the expense and hassle of redirecting and training their existing staff for project-based work.

9+
Coders
12,000
Denials
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Document all processes

Alongside that flexibility, NMG also discovered our mastery of coding quality and efficiency. We document all processes and workflows, making it quick and simple to target problem areas and take appropriate actions to prevent work duplication and streamline the workflow. Turns out, this was something NMG decided they couldn’t live without.

Shifting focus and scaling

Our quick resolution on the denials project helped NMG understand how an active denials management strategy could yield continual revenue for the correctly-coded services. As the backlog goals were accomplished and the work tapered off, it was easy to flex the number of coders again, this time from nine full-time coders to the current number of five full-time coders. Today, denials are worked as they occur by the right number of coders, with the option that NMG has to add or subtract coders from the engagements as deemed necessary by business need.

The Results

The overall results validate both the process and the participants:
  • NMG’s denial backlog was resolved quickly, efficiently and sooner than the target goal.
  • Trends were identified to prevent future denials.
  • Our proven processes were implemented for quality assurance, which sped payer reimbursements.
  • Our partnership with NMG was founded on trust and built to last.
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As a testament to growing true partnerships, here is the rest of the story that binds us with NMG. We worked as an extended business office for NMG back in 2014 when they completed a system conversion to EPIC, and we have picked up additional projects as needed. We enjoy our solid, ongoing relationship with Northwestern Medical Group and look forward to future engagements to improve revenue cycle and coding.

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