Out Patient Coding System

The agency is seeking an external outpatient coding system to ensure coding accuracy, workforce stability, regulatory compliance, and sustainable operations within an increasingly complex healthcare environment. The selected provider must assign Evaluation and Management codes, verify appropriate modifier assignments, and verify Present on Admission indicator assignments. The agency also requires the provider to manage and dispute payer coding changes through resolution and provide routine, agreed-upon reporting of these disputes to management. The scope of work requires the ability to view scanned outpatient records in OnBase and abstract data on Solve tum software. The provider must utilize the agency's ALTERA electronic health record systems and possess the ability to work directly with ALTERA. The agency requires outpatient cases to be coded utilizing current guidelines specific to medical, surgical, rehabilitation, and psychological cases. Bidders must provide a detailed description of their history performing outpatient services in connection with outpatient claims for all payers. Proposals must also include a detailed description of the number of full-time equivalents that will be assigned to the account. Eligible bidders must be onshore organizations based only in the United States, and all work must be performed offsite. The agency has not disclosed a set budget and is looking for proposals to establish pricing.