What We Do
Inpatient Services
Clinical Documentation Integrity
Ensuring that documentation is clear, precise, specific and accurately reflects both the complexity of the patient being cared for and the services being provided.
Worthy Endeavors has experience helping out organizations at any point in the CDI lifecycle. Starting a program and not sure where to begin? Have a robust program and are seeking short-term coverage? Internal department or outsourcing, which is better for you? Mature CDI program needing to transition to changing needs? These are all areas that we can help.
Medical Coding and Billing
Assigning accurate diagnosis and procedure codes to reflect services being provided and ensure accurate reimbursement and reporting.
Need full time staff or a team to manage overflow? Accurate translation of healthcare services by qualified Coding and Billing professionals optimizes revenue performance for your organization. Worthy Endeavors offers experienced and credentialed coders ensure accurate, punctual, and clean claim submissions.
Program Integrity
Ensuring queries are compliant and not leading. Utilizing proper bundled procedure codes without double billing and provider compliance with CMS.
When designed and implemented effectively, program integrity initiatives guard against fraud, waste, and abuse of Medicare & Medicaid program benefits and resources. Our experts ensure you are compliant, preventing lengthy/costly audits and investigations.
Revenue Cycle
Achieve seamless transitions throughout the revenue cycle. Optimize charge capture and commercial payer contracts. Help you focus on areas with the greatest ROI.
Understanding your chargemaster and billing practices is no easy task. To achieve best results, the Revenue Cycle needs to be an integral process within all departments. Worthy Endeavors Inc can help integrate your business operations to align with quality, CDI and utilization review.
Quality Reporting
Helping to integrate quality of care thinking into all departments of your organization. Expertise with inclusion & exclusion criteria, risk adjustment models, and value-based purchasing.
Are you capturing the complete documentation to ensure your reporting is reliable? It’s important to report quality of care accurately. Including cases that meet exclusion criteria reflects poorly on your organization. Worthy Endeavors experts see when documentation is omitting critical information which excludes cases in your reporting. Improve your rates on public reporting for mortality, complications, and readmissions, while rising in the ranks.
Utilization Review
Ensuring you’re capturing the necessary items to justify hospital admission and medical necessity. Utilization review professionals who understand level of care criteria.
Are medical necessity denials costing your organization? When you work with professionals who have experience looking at cases from the perspective of the payer, it offers deeper insight into how best to demonstrate medical necessity to justify the inpatient admission.
Data Capture & Reporting
Connecting multiple sources of data to create real time actionable information that delivers results.
Business intelligence requires taking data and turning it into useful real time actionable information. Are you using your data to its full potential? Is your software vendor delivering on what you were promised? We are experts on multiple platforms and have seen what works and what doesn’t, we can help.
Education
Providing education, mentoring and encouragement to your team. Rules change quickly and we keep your team on the cutting edge.
Health Information Management is an ever changing and complex field. The convergence of clinical care, documentation, and coding services is integral to accurate reimbursement, quality scores, and high quality patient care. View our blogs for important updates, industry insights, and information on certification, training , and governing bodies.
