PCG Software President to Speak at California HFMA Fall Conference
Presentation will address the increasing need for payers to scrutinize claims coding through technology
MALIBU, Calif. — August 27, 2007 — PCG Software, a leading provider of innovative software solutions designed to increase profitability for healthcare payer and provider organizations, today announced the company’s president will be a speaker at the Healthcare Financial Management Association (HFMA) California Fall Conference September 9-11 in Lake Tahoe. Carol Berry will address the use of technology to combat coding errors, while providing strategies and solutions to healthcare financial managers.
"Correct coding is a major issue. Providers must develop compliance plans because payers are increasingly monitoring them,” said Carol Berry, president of PCG Software. “They must develop internal investigation units, enhance their adjudication systems and develop more standardization of their processes. Equally important, providers should also use software that aids in the identification of aberrant billing,” explained Berry, whose multi-faceted background includes TPA administration, management information systems, claims administration, strategic planning and compliance consulting.
Aberrant billing exists in two ways – abusive and fraudulent, according to Berry, who will describe what specific actions constitute each offense. Berry will also discuss strategies to avoid these types of practices, such as the importance of billers using code review software and auditing before submitting claims to clearinghouses, and the importance of payers using editing software tools that correlate the history on their adjudication system with external code review tools. For payers, these tools can provide a thorough evaluation of the claim before they have to pay it.
“The simple message in all of this is that providers cannot get so busy pushing bills out the door that they forget about what is inherently important,” noted Berry, “and that is there should be a process in place in which each bill’s coding is routinely reviewed and questioned before it is submitted for payer payment. Noting that over 23 percent of all billing lines submitted to MediCare are declined, it behooves billers to embrace technology that can identify incorrect, incomplete and aberrant coding and make the corrections at the office, before the bill is submitted, not after.”
Berry will be making her presentation in conjunction with another leading coding expert, Lynn Handy, LPN CPC CPC-H CCS-P, director of coding and educational services, for The Coding Source in Los Angeles.
About PCG Software
Established in 1984, PCG Software is a leading provider of innovative software solutions designed to slow the escalating costs of healthcare. The company works with healthcare payer organizations to increase profitability and maximize financial recoveries, while assisting their provider partners to improve the accuracy of billing processes. The company’s flagship software solution enhances claims adjudication systems with more than 30 million edits per claim and uses investigative profiling reports to graphically indicate patterns of fraud and abuse. Through more accurate and efficient claims adjudication, this fraud and abuse prevention software acts as an automated cost containment system for national and regional health insurance plans, independent practice associations and third party administrators. More information about PCG Software can be found on the World Wide Web at www.pcgsoftware.com.
About HFMA
HFMA is the nation's leading membership organization for healthcare financial management executives and leaders. The organization supports more than 34,000 members, ranging from CFOs to controllers to accountants and draws its members from all segments of the healthcare industry including hospitals, managed care organizations, physician practices, accounting firms and insurance companies. HFMA maintains state chapters throughout the country. The California HFMA Fall 2007 Conference is sponsored by both the Northern California and Southern California HFMA chapters. For more information about the HFMA California Fall Conference, log here.
Press contact information:
Dave Anderson, Dodge Communications, (770) 998-0500 ext. 229
danderson@dodgecommunications.com
|
 |
