The Contractor shall perform the scope of work, provide the deliverables, and meet any delivery and completion dates outlined below: 1. Assessment of Existing Systems: Review the API’s current billing and coding systems, including software, processes, and workflows. Identify strengths, weaknesses, and areas for improvement. Evaluate documentation practices and compliance with relevant regulations. 2. Charge Master Development: Evaluate current Charge Master. CPT codes, HCPCS (Healthcare Common Procedure Coding System) codes, revenue codes, descriptions, and associated pricing. Evaluate current Charge Master to determine whether API is using the correct codes, enough codes and how we can maximize revenues. 3. Compliance and Regulatory Analysis: Assess the hospital's billing and coding practices against regulatory requirements, such as HIPAA and insurance provider guidelines. Identify any compliance gaps and recommend corrective actions. 4. Revenue Cycle Management Evaluation: Review the hospital's revenue cycle management processes, from patient registration to claims submission and reimbursement. Identify opportunities for process optimization and streamlining to reduce billing errors and improve cash flow. 5. Coding Accuracy Review: Analyze the accuracy of coding practices, including ICD and CPT codes. Conduct audits of coded claims to identify discrepancies or coding errors. Provide recommendations to enhance coding accuracy.
