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Our professional billing staff members receive individualized training, allowing them to work more effectively with individual payers and to comply with each contract’s rules and policies. Armed with the knowledge of what each payer requires to get timely and maximum reimbursement for your services, we can achieve the highest possible collection rate. We remain focused on staff training to ensure prompt charge entry, coding compliance and prompt claims processing, thereby improving the payment process. The high collection rate of accounts receivable is the result of a relentless team effort between staff in the billing office and the physician's office. This relationship allows us to obtain superior results. Contact us today for a free trial.

Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The diagnoses and procedure codes are taken from medical record documentation, such as transcription of physician's notes, laboratory and radiologic results, etc. Medical coding professionals help ensure the codes are applied correctly during the medical billing process, which includes abstracting the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.

ORKA Consulting Services specializes and caters to the home health and hospice industry, and helps you maintain the highest quality and exceptional turnaround time that leads to profitability. OASIS as a tool has too many variations/gradations which often makes it a strenuous job for a medic to answer each question correctly. What makes it more complicated if not easy, is the quarterly up-gradation of OASIS and its interpretation as published by CMS. Our team of qualified, trained and experienced auditors and reviewers, conduct comprehensive internal audits of patient data/charts / medical records to ensure absolute OASIS accuracy. They also provide the necessary support to clinicians/medic by recommending corrections in case there is any data mismatch in OASIS and also provide necessary explanations and suggestions. ORKA’s proven methods focus on quality and innovative techniques to get you the reimbursement you deserve.

Hierarchical condition category (HCC) coding is a risk-adjustment model primarily designed to estimate future health care costs for patients. The Center for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 but is becoming increasingly predominant as the environment is gradually shifting to value-based payment models. The hierarchical condition category relies on ICD-10 coding to assign risk scores to patients. Each HCC is mapped to an ICD-10 code. Along with demographic factors (such as age and gender), insurance companies use HCC coding to assign patients a risk adjustment factor (RAF) score. Using algorithms, insurances can use a patient’s RAF score to predict costs. Our CPC-certified staff with thorough knowledge of ICD – 10, RAF analysis and assessment, provide exceptional quality output and almost no rejections. Our structured team with tailored-made processes provide seamless workflow and turnaround time

Coding medical charts of patients who are discharged within 24 hours are referred to as outpatient coding. Inpatient coding involves coding the medical records of patients who are admitted to the hospital for more than 24 hours. Inpatients tend to have more complex treatment procedures.Our Team of CPC and CIC coders offer curated coding solutions to enhance your patient care and improved the revenue cycle by providing swift and thorough coding services. AAPC and AHIMA-certified coders undergo rigorous testing before receiving work from your facility. Since all our coding job is done by coders who are highly trained to review medical records and code properly, we tend to maximize your benefits in the following ways:

Coding for hospice reimbursement is becoming more complex. With OIG placing its lens on Hospice Agencies, the need for accuracy and compliance has become more important than ever. Hospice organizations are experiencing a surge in denials due to coding requirements. ORKA with its team of experienced Hospice Coders help you sail through these challenges and also we perform CDI review and provide feedback to the clinician.

Coding with OASIS and 485 (POC) review:

Healthcare revenue cycle management begins when a patient makes an appointment to seek medical services. The process ends when organizations have collected all claims and patient payments. However, the life of a patient’s account is not as straightforward as it seems.

HIPAA compliance is a living culture that health care organisations must implement within their business in order to protect the privacy, security, and integrity of protected health information.

Insurance companies can deny a patient’s request for health care coverage for many reasons. Claims that are illegible, not specific enough, missing information, and not filed on time are some primary reasons for insurers to refuse to cover patient healthcare services. Utilizing a professional CDI will ensure claims are meticulously completed, easy to understand, and filed on time, thereby minimising the chances of denial of the patient’s claim. Clinical documentation improvement (CDI) will enable physicians to properly input information and complete data into patient records. This will smooth out the healthcare process for other providers caring for the patient and coders. This allows medical coders to conduct medical reviews of reliable and completed patient documents and treatments and assign codes with precision. At ORKA, we have certified and experienced trainers who teach the documentation techniques necessary to improve reimbursement. They can help coders to know to understand what to look for to support different levels of severity and depth of care. They assist physicians in clarifying and identifying the requirements for precise and complete documentation. They can also provide training on relevant compliance concerns.