SCALE’s Client, who provides emergency medical and specialty hospital services with facilities in thirteen states., desired a thorough understanding of its current medical coding & documentation practices and how they compared to best practices and OIG requirements. The Client, who also oversees independent physician associations (IPAs) and managed service organizations (MSOs) that staff these facilities, wanted to provide education & training to coding staff to mitigate financial and compliance risks associated with recent findings. SCALE was engaged to perform a baseline gap assessment of current documentation and medical coding practices for facility and professional
services claims.