1. North Carolina Medical Society Quality of Care and Performance Improvement Committee August 7 th, 2009 Presented by: Mary Jane McCracken, RN

2. A local medical record coding and data abstraction service company Coding vacancy rate nearly 20 percent –Payment backlogs Recent and emerging coding/documentation challenges –MS-DRG, POA, RACs, MICs, ZPICs, ICD-10 Increased public reporting initiatives/incentives –PQRI, RHQDAPU, BTE, NCQA Lack of coding & data abstraction staff expertise

3. Two Core Business Services Health Information Consulting Services Inpatient/outpatient/E&M coding –Prospective or retrospective coding reviews Compliance auditing and monitoring –Review of coding and supporting documentation –RAC readiness review General and customized coding education –Hot topics or review of frequently used codes –Customization based on results of audit/monitoring

4. Two Core Business Services Data Abstraction Services Data collection for quality measures –PQRI, RHQDAPU, HEDIS, BTE, NCQA –Facility specific performance measures –State focused care studies Clinical research support –Academic clinical studies Clinical registries abstraction –Record review / data entry

5. Our Coding Staff Experienced staff of > 10 credentialed health information professionals located throughout the state Average coding/auditing experience > 10 –ICD-9-CM, CPT, and E&M –Inpatient/outpatient hospital settings –Same day surgery/ER and ambulatory –OIG and RAC auditing –Denial management of claims –Superbill/chargemaster reviews

6. Our Data Abstraction Nursing Staff Experienced staff of > 30 nurse data abstractors located throughout the state Average abstraction experience > 5 years –Clinical studies –Registries –Quality measures Experienced working with physician offices/hospitals/surgical and dialysis centers/EDs and dental practices Proficient with electronic and paper records

7. Provider Outcomes Revenue enhancement –Backlog reduction, improved accuracy, cleaner claims Reduce the risk of a charge of fraud –Improved compliance –Documentation that supports medical necessity –Understanding of regulations and how to stay up-to-date Local staff, quality work & competitive pricing

8. Questions?