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Coding and Billing Management

Coding and Billing Management

Encoder Product Suite

The Encoder Product Suite provides an intelligent, comprehensive approach to VA inpatient and outpatient data management technology for the HIMS, Billing, Utilization Review, Accounts Receivable, and Compliance departments.

The Encoder Product Suite includes Windows graphical user interface modules of various VistA packages with coding, compliance, billing, and auditing functionality. It provides VA staff and management with the tools needed to do their jobs effectively. With the official VA-sanctioned communication technology, RPC Broker, the system provides real-time integration into VA packages, such as Patient Care Encounter, Patient Treatment File, Computerized Patient Record System, and Surgery. This integration ensures that all of the necessary data and documentation is available to staff directly involved with coding and billing of accurate, comprehensive claims for the VA.

Benefits:

  • Improves auditing and monitoring capabilities with VA-specific Veterans Equitable Resource Allocation (VERA) tools
  • Improves coding knowledge with real-time error indicators
  • Identifies “high-risk” coding practices
  • Reduces claim denial with CMS 1500 and UB-04 claim scrubbing
  • Improves screening capability for claims and encounters
  • Improves reporting capabilities with an ad hoc report builder
     

Encoder Product Suite-Central Reporting (EPS-CR)

EPS-Central Reporting (EPS-CR) provides the Veterans Affairs Central Office (VACO) with centralized reporting of the VA medical centers’ Encoder Product Suite (EPS) data. The focus of EPS-CR is to support the VA’s goals of monitoring coding timeliness and accuracy, while eliminating the reporting of HIM metrics that are unsubstantiated.

EPS-CR consolidates specific coding metrics from VA medical centers across the U.S. It offers reliable, consistent, and automated reporting of inpatient and outpatient data at the VA medical center (VAMC), Veterans Integrated Service Network (VISN), Consolidated Patient Account Center (CPAC), and national levels.

Using an intuitive, graphical dashboard, VAMC users can quickly identify data trends, spot anomalies and outliers, and perform other business intelligence analyses of coded data.

Benefits:

  • Provides a national dashboard view of VAMC EPS data via the Veterans Support Service Center (VSSC) HIM Dashboard
  • Enables thorough analysis, comparison, and trending of national EPS data across various time periods, and detailed “drill-down” analysis by CPAC, VISN, and VAMC
  • Eliminates unsubstantiated self-reporting via silent report processing, as EPS data is sent automatically to the EPS-CR central database
     

 

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