LexiCode Coding & Reimbursement Synchronization

Coding & Reimbursement in Sychronization

Incorrect coding as applied to contractual reimbursement methodologies often results in overpaid claims

Exela’s proactive measures maximize cash, reduce rework and enhance provider and member satisfaction.
Call us to discuss how we may help you Get It Right The First Time, All The Time.

Exela Process:

1. Receive Claim Data

   837 claim data

2. Evaluate key coding risk areas

   Medical Conditions & Coding Guidelines

3. Review Third Party Payer Agreements

   Calculate Financial Impact of coding correction

4. Request Medical Record as Required

   Documentation Review

5. Analyze Inpatient Claims

   DRG impact & Reimbursement impact

6. Analyze Outpatient Claims

   Procedure coding & Reimbursement impact

7. Flag future occurrences

   Prior to payment to prevent errors

8. Request Provider correct “Prior To” claim submission

   Future systemic improper coding

9. Calculate Net Financial Impact

   Initial Payment vs. New Payment due to coding correction