Who Needs QualityEx Solutions

QualityEx uncovers data once hidden in your EMR system by allowing you to proactively search and find inaccuracies in patient billing and coding, improve patient care through better compliance, and inform clinician training programs.

Compliance & Audit

  • Identify if cloned notes resulted in fraudulent billing to improve revenue integrity
  • Confirm patient record accuracy
  • Provide improved patient care by avoiding medical errors due to irrelevant or outdated information that was copied/pasted into the record
  • Establish clinician education by identifying unacceptable practices and developing policies to train and measure staff on use of copy/paste

Billing & Coding

  • Ensure implementation of new billing codes
  • Confirm billing code accuracy
  • Document proof-of-service evidence 
  • Train and educate staff once you’ve pinpointed billing and coding error by department or individual

Revenue Integrity Group

  • Reduce revenue leakage by uncovering lost revenue and identifying incorrect codes on claims, insufficient access to code changes and compliance regulations, inconsistent assignment of CPT codes, missing codes, lack of communication between clinical and financial staff, pricing that doesn’t cover costs, inefficient internal processes, and more
  • Confirm physician compensation by ensuring clinicians are not compensated for patient care they did not perform

Health Information Management

  • Ensure coded data is input accurately into the patient record by identifying instances of potential abuse of patient note cloning
  • Automatically identifies suspect activity to provide a clear picture you can share with departments or individuals for training and education programs, as recommended by the Centers for Medicare and Medicaid and the Department of Health and Human Services