ASC RCM AND BUSINESS INTELLIGENCE LEADER GENASCIS™ LAUNCHES POWERFUL CODING COMPLIANCE TECHNOLOGY.
CHICAGO, Ill. - October 8, 2009 - ASC Revenue Cycle Management and Business Intelligence leader GENASCIS™ (www.genascis.com) today introduced its groundbreaking new web-based technology, CODECYPHER™ (pronounced “code decipher”) a “Coding Compliance Engine” developed in partnership with medical coding, compliance and payment authority Medical Learning, Inc. (www.medlearn.com). GENASCIS and MedLearn unveiled CODECYPHER at an ASC conference in Chicago.
“Using CODECYPHER Coding Compliance Engine, an ASC can quickly, easily, and economically run a customized coding analysis that zeros in on critical compliance issues, risks and opportunities, as well as generate case-specific decision support on mitigating financial risks and taking advantage of increased reimbursement opportunities,” said Ed Gallo, GENASCIS CEO.
“CODECYPHER uniquely combines proprietary technology developed by GENASCIS with MedLearn’s extensive knowledgebase and audit data to perform complex analysis of an ASC’s medical records and coding going back two years plus the current year. This technology is therefore able to pinpoint the incorrect usage of modifiers, as well as certain CPT codes, as the most common and worrisome causes of both overpayments and underpayments for outpatient surgical procedures,” added Kathleen Harris, GENASCIS senior vice president of sales, marketing and product management.
Specifically, CODECYPHER has determined that Modifier 59 is most often reported incorrectly by ASCs of all sizes; on average, about 50% of the time. Accordingly, this new technology runs automated analysis of an ASC’s claims to address the following key areas of concern:
- Procedure combinations with potential Modifier 59 misuse
- Procedure combinations billed with NCCI Mutually Exclusive codes
- Opportunities to increase revenue by billing Modifier 59
- Procedures with inappropriate modifiers for ASCs
According to MedLearn president Mike Rogge, “CODECYPHER was used to analyze six participating beta test ASCs comprising a total of more than 65,000 accounts, and red-flagged 38% of those cases (24,700). To validate CODECYPHER’s efficacy, MedLearn conducted a full manual audit of a randomly selected sampling of the flagged accounts and found that within that audit sample, 51% of the claims contained misused modifier codes, as well as other coding errors. Our conclusion: of the 24,700 cases CODECYPHER flagged, nearly 12,600 had misused modifier codes.”
“RAC audits for ASCs are a looming likelihood, and most all ASCs of every size and organizational structure are not prepared to pay back revenue long-since received due to compliance errors, nor face penalties associated with those give-backs. We firmly believe now is the time for every ASC to heed the advice of the Office of Inspector General (OIG) and proactively implement its own internal compliance program. CODECYPHER can quickly become the centerpiece of that strategy,” concluded Harris.
For more information about CODECYPHER Coding Compliance Engine, contact GENASCIS sales at 866.208.7348, extension 265, or MedLearn sales at 800.252.1578, extension 3410.
About GENASCIS:
The company was created by integrating the services of firmly established, industry-leading business entities in the ASC space. Prior to consolidating under the GENASCIS brand, PMG Partners was the nation’s leading provider of technology-enhanced revenue cycle services for ambulatory surgery centers and specialty physicians. MEDIBIS designed and built the surgery center industry’s only analytical, business intelligence and benchmarking software. And GIT was widely acknowledged as the premier resource for transcription and clinical coding services for ASCs and specialty practices. Collectively, GENASCIS offers an unmatched understanding of ASC commerce, powerful proprietary technology solutions, as well as high quality in-demand human resources. With corporate headquarters in Los Angeles, Calif. and offices in San Diego, Calif. and Oklahoma City, Okla., GENASCIS has over 400 employees and currently works with more than 700 surgical centers and specialty physician practices in 44 states. For more information, visit www.genascis.com.
About Medical Learning, Inc. (MedLearn):
Since its founding in 1991, MedLearn has become one of the nation’s most respected authorities on medical coding, compliance and payment. MedLearn clients can choose from a variety of resources, including publications, consulting services, customized learning and assessments, seminars and online testing and learning. Content for each of these resources comes directly from MedLearn experts, professionals who have years, often decades, of real-world experience in the clinical and business office settings.
Media Contacts:
Kathleen Harris
Senior Vice President
918.607.7447
kharris@genascis.com
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