The CDM is the mechanism for charging services and assigning appropriate billing elements from the claim form. Facility and/or professional billing can be impacted by incorrect CDM information. The CDM is easy to fix, time consuming, and requiring of rigorous attention to detail, but takes more time if not fixed. CDM fixes typically fall below the radar as a priority for most providers. KHC has options to match your needs for putting the pieces together for your CDM in a timely and cost-effective manner.
Our CDM professionals can review the complete CDM for all departments and specialties. A more focused CDM review may target specific clinical areas or specialties and can include a review of operational workflow as well as individual charges within the Departments. Our organization focuses on a customized approach to each client’s special needs. Your CDM is not a “one size fits all”, so the approach towards finding solutions is unique to your needs. We offer:
- Comprehensive CDM Review: This review includes all Departments of the Hospital or clinical areas of physician practices. The complete CDM is analyzed using current billing and coding data requirements. Department Managers are enlisted to review process flow and charge capture for each area and each service. The review tempo is dictated by the client and is guided by a review work plan, established with the CDM review project manager from KHC.
- Fast Track CDM Integrity: KHC performs all of the above tasks, but with a more aggressive schedule that completes the entire review on a fast track.
- Basic Desk Audit: KHC reviews the complete CDM noting any potential coding, description, or reporting issues. This review provides a high level overview and catches errors that might have slipped through.
- Annual CDM Update: This review focuses on CPT/HCPCS codes. It assesses current codes assigned in the system and provides recommendations for new, revised, or deleted codes. This is done once per year, typically at the calendar year end to prepare for January 1 coding changes.
- Consolidation/Enterprise CDM: Many enterprise health systems or centralized billing office (CBO) set-ups are moving to one “master” CDM to facilitate maintenance and ensure consistency from provider to provider (regardless of their physical location). Our team verifies the “master” CDM and then validates the additional information for all other entities.
- Department or Practice Specific CDM Review: This allows a deep dive into a department or practice with known or suspected concerns. The CDM is analyzed using current billing and coding data requirements. KHC meets with Department Managers to learn the process flow and charge capture.
- Help Desk/On Call Support: KHC offers an easy to use Help Desk to respond to questions arising throughout the year. For an established retainer, your staff has access to the full continuum of CDM experts on the KHC staff. Questions are e-mailed to our team, communicated to the appropriate team member, and answered in two (2) business days or less (exceptions may occur and will be communicated on a case-by-case basis). Hours are deducted from the retainer balance. If the retainer fee is not used, it can be rolled to the next year.