PURPOSE
An APC review can assist facilities with the following:
1. Identify if facility is accurately assigning codes.
2. Analyze charges generated by the ancillary departments to ensure they are integrated and interfacing correctly to the UB-92.
3. Assessment of overall billing cycle from submission of claim to accuracy of payment relating to APC assignment.
4. Provide expert knowledge to areas requiring Intensive Education.

METHODOLOGY
The APC review can be done on-site or off-site using YPRO's ImageCode.

The APC review consists of reviewing medical records including Outpatient/Ancillary, Same Day Surgeries, ER records, and/or Clinic visits. We validate each record for coding, documentation and compliance accuracy, as well as to verify correct assignment of APC groups. We review the medical record, the UB-92 and the remittance advice to make sure that all the information is correctly transmitted and that the reimbursement is correct.

YPRO provides education for your coding staff. The findings from the review are complied into a summary report that is give orally to your staff, allowing them the opportunity to ask questions and get feedback. Those attending the oral summary can earn 1 CE unit. The client is also provided with a detailed written report to provide for future reference and to assist the client in meeting compliance regulations.

BENEFITS
· Improve accuracy of CPT coding
· Improve APC assignment
· Improve reimbursement
· Improve regulatory compliance
· Reduce denials
· Improve cash flow

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