IRCF

Integrity Revenue Consulting of Florida

ABOUT US

We offer a unique approach to Manage Care Organizations and physicians practices for more than 8 years. A team of seasoned professionals with clinical background and active Coding/Billing certification with AAPC in the areas of Risk Adjustment, Utilization and Quality Star rating program. This team of experts works through a client’s data from a global perspective to maximize financial opportunity providing guidance to physicians to ensure adequate clinical record-keeping. Advices on initiatives for improvement in documentation and coding accuracy.

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Providers/Staff Tools

Quick Guide MRA & Coding guidelines
New Patient Medical Records Form Questionnaire
EHR system templates updates
HEDIS Tools for Providers
HEDIS Tools for office Staff

Chart Audit Tools

MRA Spreadsheet Tracking Report
CMS 2021 HCC, HHS and RxHCC Models
2021 Star Rating Quality Measures Guidelines
Additional MRA&Coding guidelines

LET’S GET YOU
THERE

OUR Services

Management Consulting

Practice Management Consulting for Primary Care Offices.

Offices workflow daily operations
Providers/Staff Hiring /interview
Value Based Care payment model
Payers acreditation process
KPI’s
EHR system set up
Risk contracts

Chart Review Audits

Medicare Risk Adjustment (MRA)
HEDIS/Star Rating
MRA

1 – 100% Membership Comprehensive Chart Review

2 – Retrospective /Prospective Initiative

3 – Payers Unreported Chronic Conditions Validation

4 – Clinical Documentation Improvement process

HEDIS/Star Rating

1- 100% Membership Comprehensive Chart Review

2- Payers Quality Gaps reports Validation

3-HEDIS /Star Rating implementation tools

Educational Trainings

Risk Adjustment Training presentation for Providers
Risk Adjustment Training for office Staff
Star Rating Training presentation

WHY US?

RESULTS

We provide value-added services based on clinical evidence techniques approach to make easy for providers understand.

TARGETING

We are in compliance with CMS proper documentation and coding to the highest level of specificity

RESEARCH

We ensure integrity and data used to calculated risk score.

FAQ

What is MRA?

Medicare Risk Adjustment

What is HEDIS?

Healthcare Effectiveness Data and Information Set

What is utilization and management?

Utilization Management- Review of services to ensure that they are medically necessary, provided in the most appropriate care setting, and at or above quality standards.

How to use our tools?

We will guide step by step during our trainig.

What is included in all chart audits?

MRA Spreadsheet Tracking report with details below:

Rendering Provider name
Member Demographics (Two )
Payers Name
Chronic Conditions ICD-10 Codes
Chronic Conditions Categories : ADDED-SUSPECT-DELETED
LOV (Last Office Visit date will help to identify members not seen 4 times a year)
NOV (Next Office Visit date will identify if members are been schedule for future visits)
Conditions Query for ADDED-SUSPECT
Claim code validation Status
Member Chronic conditions Screening Test Opportunity
Member Old Providers Medical Records opportunity
Disease Management/ Case Management opportunities.

How secure is my revenue?

We guarantee your revenue 100%

407-534-0010

yrg@ircoflorida.com

Contact us

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