Provider consulting services

CGI delivers innovative revenue cycle solutions to help hospitals, health systems and other healthcare providers maintain complete and accurate records, proper coding and thorough documentation to improve their bottom line. Our professional team includes experts in reimbursement, finance, operations, documentation and coding, compliance and information technology.

Services:

APC

CGI’s consulting team reviews charge capture, coding, documentation and billing procedures to identify and correct problems related to APC implementation. We develop and evaluate APC implementation plans and provide training to assure that administrative and clinical staffs understand coding and documentation requirements to assure appropriate reimbursements.

• Brochure – APC Assessment and Implementation

Charge description master (CDM)

CGI provides CDM services to update, correct and standardize a health system’s CDM and order entry process organization-wide. Services include ongoing order entry maintenance, annual CDM reviews, peer pricing comparisons and training to ensure a complete and accurate CDM.

Coding, documentation and compliance services

CGI’s consulting team reviews coding and documentation procedures to identify and correct coding and compliance errors. We have developed a proprietary analytical tool to improve inpatient ICD-9-CM coding for appropriate DRG assignment and outpatient HCPCS, ICD-9 coding and documentation.

Electronic health records (EHR)

CGI helps providers prepare for the global progress toward the adoption of EHRs. We focus on those EHR solutions that deliver immediate and measurable value.

• Webcast – Tackling Electronic Health Records

Operational review

CGI’s clinical and operational consultants redesign staffing and workflow patterns and recommend cost-saving procedures to improve efficiencies department-by-department, or hospital-wide.

Regional health information organizations (RHIOs)

CGI is a thought leader in the development of RHIOs, and is currently engaged as one of four teams building a prototype National Health Information Network for the U.S. Office of the National Coordinator of Health Information Technology.

• Webcast – Tapping the Power of your RHIO
• White paper – The Provider’s Perspective of RHIO Participation

Reimbursement consulting

CGI helps hospitals and health systems implement new inpatient and outpatient reimbursement systems, including Medicare’s prospective payment systems (PPS) for inpatient rehabilitation facilities. We evaluate the reimbursement impact, identify opportunities to improve reimbursement and provide extensive training to clinical staff. We also evaluate and prepare Medicare cost reports, and prepare rate appeals for Medicare and Medicaid reimbursement.

Strategic pricing

CGI utilizes its proprietary pricing software to help hospitals develop and implement strategic pricing plans to maintain revenues. We establish item-level prices for commercial contracts and Medicare outliers (both DRG and APC), and help hospitals analyze the financial impact of each possibility before implementing any pricing changes.

Strategic planning

CGI helps healthcare providers improve their competitive market position, identify new revenue opportunities, and improve profitability with short- and long-range strategic planning services which include: business plan development, turnaround services, market assessment and marketing communications services.

Training

To help clients realize the benefits of strategic benefits long-term, we offer training for medical, clinical and administrative staff on documentation, coding, billing, compliance and HIPAA. We provide on-site, CD-ROM and Web-based training.