Ingram & Associates

Reaching the gold standard for healthcare revenue cycle, financial and coding performance

Ingram focuses solely on one your toughest areas of medical coding: Interventional radiology and cardiology special procedures (also commonly known as CVIR) typically performed in angiography rooms, cardiac catheterization labs and in the operating room to ensure appropriate reimbursement and coding compliance under APCs. Ingram provides assessment audits, coding services for both historical and on-going cases, educational programs and complete turnkey re-engineering services designed to build “best practices” capabilities within organizations coding for special procedures.

"What makes Ingram's ZHealth Division different is our exclusive focus on interventional radiology and cardiology—and our experience both as practitioners and as coders. It's perhaps the most complex Medicare compliance and reimbursement area where hospitals need coding help."

Dr. Zielske also heads up ZHealth Publishing, a firm dedicated to producing professional coding reference manuals and related materials for the interventional radiology and cardiology areas..

Over the past three years Dr. Zielske and his colleagues have worked with more than 225 hospitals to provide a range of interventional radiology and cardiology coding and compliance reviews (audits), retrospective and prospective coding services, and educational programs dedicated to improving compliance and coreecting reimbursement as a result of mandated APC's. To date, Dr. Z and his physician colleagues have created the largest known database on case coding experience related to interventional radiology and cardiology. in addition, Ingram is proud of its client relationships and has had the pleasure of working with many of the most prestigious hospitals across the country. Ingrams extensive case experience allows clients to continually track national trends on interventional radiology and cardiology compliance and reimbursement results and compare their coding and reimbursement results to key national and regional benchmarks.

For a quick read to estimate your hospital's potential reimbursement and compliance improvement see Ingram's Medical Billing calculator.

A Coding & Compliance Review by Ingram is an informative, low cost, and rapid first step that evaluates a hospital's actual experience in interventional or cardiology case coding, measures accuracy and compliance to mandated national coding standards, and determines reimbursement impact. Ingram uses copies of actual outpatient billed claims and physicians dictated reports to show where your hospital stands compared to the national data so that you can benchmark your own organization's potential compliance risk and reimbursement exposure for special procedures.

Ingram's Prospective Coding services are geared to the hospital that chooses to outsource the coding of its complex CVIR cases on a go-forward basis. Because of the complexity of this unique coding area and the clinical knowledge required to successfully manage the coding process, your organization may choose to outsource the coding of complex CVIR cases to Ingram's physician coders. Since case volume is so low (typically less than 5% of the radiology procedure volume), this is a very manageable task for insuring coding compliance and proper reimbursement.

Complex inpatient and outpatient CVIR cases are forwarded daily to our team of physician coding experts to correctly code each case and return that information to you. Ingram's Prospective Coding process supplements your existing billing process to insure that these cases are correctly coded and charged on an on-going basis.

If a coding & compliance problem is found via an Ingram Coding & Compliance Review, many hospitals will elect to audit and correct their outpatient cases on a retrospective basis. The benefit is two-fold. First, retrospective coding will correct historical problem cases and get you in coding compliance since the mandate under APCs went into effect August of 2000. Second, it ensures that appropriate and correct reimbursement has been received for all past cases and your future liability under potential compliance audits will insure you aren't at signficant risk.

If your hospital is interested in tackling the necessary work process changes and skillset development necessary for coding success in these areas, Ingram's Medical Coding Educational program is geared to support your internal process improvement & educational initiatives. Because of the complexity of complex special procedure coding, Ingram's educational development programs are not geared towards one-time "seminar" sessions--as these have traditionally been ineffective in skill development in the specialty area of interventional radiology & cardiology coding. Rather, Ingram focuses on a curriculum approach combined with monthly case reviews of all your coding to provide the basis for developing the skills and expertise in becoming coding independent and benchmarking your progress to successful completion.

The educational component begins with an intensive 2 1/2 day off-site training seminar. Ingram's Educationl programs usually run three to six months or more and are designed to build your staff skills, maintain compliance, and provide your hospital with the tracking of coding results to ensure your success and maintain compliance during the process. Educational sessions are taught both by members of our clinical physician team and our special procedures consulting staff and focus on the unique aspects of special procedure coding.

	Anatomy
	Terminology
	Component / CPT Coding
	Modifiers & Pass-through's
	Federal Coding Standards / SCVIR
	Special Procedure Coding Work Processes
	Personal Case Reviews with Physician Coders

Turnkey Re-Engineering & Educational Program

Ingram's most comprehensive program encompasses every aspect of the hospital process for interventional radiology or cardiology coding designed to effect maximum positive "best practices" change in the fastest possible timeframe. This complete program is provided under a single consultancy fee arrangement and incorporates all the potential problem areas into a comprehensive evaluation, documentation, recommendation and implementation strategy for your organization. This year long process is broken into three phases:

Our evaluation team will spend several weeks on-site to evaluate and interview the various departments involved in any aspect of the coding and billing process (from radiology, the cath lab, the operating room, medical records/HIM, IT, business Office and compliance departments) to gather key work process data that will be used in making final recommendations for change. This process includes evaluation and recommendations on a number of topics including but not limited to:

The completion of this phase concludes with complete documentation of the existing workflows and operational deficiencies and provides detailed recommendations for changes necessary to achieve a successful "best practices" environment.

A comprehensive educational process will be completed along with the implementation of all related work process recommendations to insure your organizations success. Please see the section entitled Educational Programs above for more information on the training curriculum.

During the entire re-engineering process, our physician coding team will provide coding of all new cases you wish to send Ingram, both to support the transitional period from evaluation to implementation, as well as to provide the appropriate post educational feedback on your internal post-education accuracy to insure that the work processes and knowledge building steps are working successfully. Both monthly and quarterly performance benchmarks will be provided as compared to the original benchmark data generated from your original audit process. Quarterly teleconference meetings will be available to provide "mini" educational reviews of problem cases and areas requiring additional improvement.