Decision Health E/M ProCheck

As a practice management and revenue consultant, I found DecisionHealth's E/M ProCheck to be a must-have business tool.

Their "productivity analysis" is a compliance tool that both small and large practices should not be without. This particular feature gives providers an idea of how their E/M coding compares to other providers of their specialty and location. It also compares their relative frequency with that of a national
average as well. Personally, I would like to see all my clients participate with CERT - Comprehensive Error Rate Testing (a program created by CMS Centers for Medicare and Medicaid Services to measure paid claims error rates compared to other providers of same specialty and location) as well as regularly using this tool. It provides a fi rm foundation for knowing where your organization needs additional education or improvement in case of future audits.

There is access to the 95 and the 97 guidelines (coding guidelines developed by CMS/ AMA), which is important because you can use either as long as you are consistent. There is even a handy feature, which allows a place for the physicians to leave notes as well as notes for the person using the auditing tool. You can save previous audits and reports and print out a beautifully formatted result of your audit for your compliance and education records. This tool is user friendly and is a great companion for anyone who is looking to validate their E/M coding skills.

I was able to utilize this tool to successfully appeal a "downcoded" claim by a carrier. During my denial management process, I determined that the carrier had deemed on its own that one of my providers claims had not substantiated the level which had been billed for a new patient exam. I used my own audit process and submitted an appeal letter. I am able to back it up with the beautiful copy of the audit from the E/M ProCheck to further validate my results. It makes their case indefensible.

By having this product available via the Internet, I am able to use it anywhere, which is very convenient for a traveling consultant or a provider with multiple locations.

Decision Health E/M ProCheck
Don't wait, subscribe to E/M ProCheck today and save $100


Review by: Merrilee Severino, CPC, CMM, CPM, NC
MS Physician Practice Management and Revenue Consultants, Corp