Comprehensive, real‑time coded record monitoring and review
Reduce or eliminate reimbursement delays and audit risks by monitoring and updating records to meet regulatory and payor standards before being billed. Improves the quality of claims data and acts as an early warning system to identify and reduce potential audit vulnerabilities.
Benefits
Reinforce coding accuracy
Nuance Clintegrity Coding Compliance enables facilities to establish comprehensive and customizable pre‑bill rules based on claims data or user criteria such as payor contracts, physicians, denial details, and coding information. These rules can be activated immediately to comply with rapidly changing quality, payor, and regulatory requirements.
Models future reimbursement expectations based on more complete coding.
Helps ensure accurate and complete coding of the medical record to protect against non‑compliance.
Reduces risk of penalties and take‑backs from OIG, RAC, or other payor audits.
Tracks progress against specific goals, identifies performance trends, and uncovers possible areas of improvement.
Features
Comprehensive knowledge base
Help your staff address the growing number of clinical, financial and regulatory changes including CMS updates, Office of Inspector General (OIG) targets, Revenue Edits, Data Quality Edits, and AHA and AMA coding guidelines.
Enables users to create, activate, or disable edits to respond immediately to changing quality, regulatory, and payor requirements
Assesses the value and impact of compliance to drive potential changes and updates to selection criteria and identifies opportunities for additional coder education.
Provides the flexibility to address regulatory and compliance needs unique to a specific organization. Comprehensive selection criteria can be set up based upon claims data or user criteria including payor contracts, denials information, quality and performance initiatives, coder specialties, service lines, physicians, codes and code sets.
Includes current Federal and payor regulations and established industry coding guidelines and practices. Standard and ad‑hoc reports provide insight into compliance edit effectiveness and outcomes.
Complementary solutions
Nuance Clintegrity Facility Coding is an easy‑to‑understand encoder that empowers coding staff with critical clinical, financial, and regulatory information essential for complete and accurate reimbursement.
Nuance Clintegrity Physician Coding is a comprehensive encoder that provides staff with the critical information necessary to improve professional fee coding productivity and ensure accurate reimbursements.
Additional resources
- Nuance Clintegrity Coding Solutions and Services(pdf. Open a new window)
- Nuance Clintegrity Facility Coding(pdf. Open a new window)
- Nuance Clintegrity Physician Coding(pdf. Open a new window)
- Nuance Clintegrity Coding Compliance(pdf. Open a new window)
- Nuance Clintegrity Enhanced Workflow(pdf. Open a new window)