MediConnect Global recently announced the availability of an enhanced module within its proprietary cloud-based RapidReview workflow system that improves the ease with which health plans can validate provider claims data. MediConnect counts four of the top five health plans in the United States among its clients.

The new Provider Claims Coding Validation and Scoring module easily imports the pertinent claims information such as diagnostic codes and dates of service into an online coding form. A coder then can either validate each ICD-9 code billed by the physician or capture any errors and omissions coded by the physician. This new module simplifies the review process for any coder.

"In order to ensure proper claims submissions, it is vital that not only are the correct diagnostic codes used, but that each date of service has all the required information, such as signatures and documentation," said Amy Rees Anderson, CEO of MediConnect. "By isolating the necessary information, coders are able to quickly review the quality of the providers coding and determine where additional provider education and follow-up is needed."

The new module also generates provider scorecards that show health plans how effective each of their providers are at coding their charts. Additionally, health plans can produce educational reports to give their physicians that indicate what areas need improvement in order to improve their overall coding quality.

"The healthcare system is a complex infrastructure with many moving parts, and the provider score card and educational reports are great tools for health plans to monitor compliance and measure accountability," added Anderson. "Being able to identify the areas of improvement for a physician and provide guidance on how to achieve it will help eliminate coding errors, which leads to better physician documentation and the submission of more accurate claims."