ProFee, or professional fee, refers to coding and billing the physician side of a patient encounter. ProFee coding covers the work performed by the provider and the reimbursement they will receive for the medical services performed.
Because Profee billing directly affects providers, it can be more strict than other types of accounts. Because of the narrow margin for error as an auditor, ReviewMate is prepared to address the exact punctuality you need.
ReviewMate E/M auditing tool ensures that physicians’ offices provide the correct information for insurance reimbursement by analyzing complex code assignment options and identifying opportunities for increased revenue, including ways to reduce compliance risks.
ReviewMate E/M (Evaluation and Management) auditing is part of our ProFee Module; it is designed to assist auditors in assessing the accuracy and compliance of E/M coding in medical records. It helps ensure that the service levels documented in the medical records align with the appropriate E/M codes defined by the Current Procedural Terminology (CPT) guidelines.
E/M Coding Guidelines Integration: Integration of the latest E/M coding guidelines established by the Centers for Medicare and Medicaid Services (CMS) and other relevant regulatory bodies.
Scoring and Compliance Assessment: Scoring mechanisms to evaluate the compliance of E/M coding with industry standards and regulations, providing detailed insights into potential areas of non-compliance.
Educational Resources, Coding Edits, and Training Modules: Access to educational resources to help coders stay up-to-date with the latest E/M coding guidelines and best practices.
Real-time Feedback and Recommendations: Real-time code lookup and code information details to guide reviewers to accurately identify the appropriate E/M codes based on the documented patient encounters.
Customizable Reporting: Customizable reporting features allow users to generate comprehensive reports highlighting coding trends, areas of improvement, and compliance status.
Integration with EHR Systems: Integrating Electronic Health Record (EHR) systems to streamline the E/M coding process and facilitate seamless data transfer between healthcare IT platforms.
Compliance with Regulatory Standards: Adherence to relevant regulatory standards, including HIPAA (Health Insurance Portability and Accountability Act) regulations and other industry-specific compliance requirements.
Audit Trail and Security Features: Robust audit trail functionalities and security measures to track user activities, maintain data integrity, and ensure the confidentiality of sensitive patient information.