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Bill Dunbar and Associates LLC (BDA) provides revenue management consulting services with an emphasis on compliance, documentation, coding and reimbursement. They have successfully improved the financial performance of hospitals, physicians and providers through medical documentation and coding accuracy since 1988.


​​ ​​Upcoming Webinar: Partner Perspectives

Topic: 2023 Evaluation and Management Updates and the Impact
Date/Time: Thursday, Mar. 2  |  2 – 3 p.m. ET
Presenter: Terri Scales, CPC, CCS-P, National Director of Business Development, Bill Dunbar & Associates
Target Audience: C-Suite, HIM, Billing, Rev Cycle
Register: https://us02web.zoom.us/meeting/register/tZYofuurrDojH9Br871Tj-hfCgQcItS1jwXM

Documentation and Coding for Evaluation and Management (E/M) services made landmark changes for the Outpatient / Office code set in 2021. On Jan. 1, 2023, the AMA and CMS revised the documentation guidelines for all other visits to coincide with the changes made in 2021. Why is this important? When the documentation and/or coding are not accurately reported, the provider and/or the organization run the risk of an audit. The selection of an inaccurate code can cause claim down codes or denials which can slow the reimbursement for the services rendered. Knowing and understanding the 2023 coding changes allows each organization to document and code successfully.

Terri pic.JPG Terri Scales, CPC, CCS-P

Terri Scales, CPC, CCS-P is a National Director of Business Development and Regional Director of Client Services with Bill Dunbar and Associates.  

Terri has obtained her professional coding certifications as a Certified Professional Coder (CPC) from the American Academy of Professional Coders and also a Certified Coding Specialist Physician Based (CCS-P) from the American Health Information Management Association (AHIMA).  Terri served as a National Advisory Board Member to the AAPC from 2009 to 2011, which at the time represented over 100,000 members. Terri’s passion for this field helped grow the organization to where it is today.

Her responsibilities as a Regional Director for each client include, Provider and Staff documentation and coding education, analysis of EMR templates, providing annual updates for CPT and ICD-10, along with claim form reviews. She also has over 25 years of health care experience with an emphasis on clinic management, coding and insurance billing, and State Specific Workers’ Compensation Regulation and Compliance. 



Blog Posts

BDA HCC ReClaim: A Success Story –​ BDA HCC ReClaim.pdf


Dunbar Information Vault On-Demand  IHA has teamed up with BDA to provide our members with access to BDA's MyDIVO.com (Dunbar Information Vault On-Demand). DIVO will contain the latest information available regarding documentation and coding from the professionals at BDA. Be on the look-out for this online knowledge base coming soon.


HCC Capture and Recapture Whitepaper   Healthcare organizations should monitor their value-based payment models.  Learn more about an IHA Endorsed Business Partner, BDA HCC ReClaimTM​, in their downloadable HCC Whitepaper.pdf

 

BDA Medical Compliance, Documentation, Coding, and Reimbursement Consulting Solutions – BDA's success is based on partnering with our clients to create a culture that is committed to an effective Outpatient Clinical Documentation Improvement (Outpatient CDI) program.  BDA's typical net revenue improvements after full engagement are: Emergency Department Facility – 20-25% and Physician Practices – 10-15%. https://billdunbar.com/documentation-and-coding/

 

BDA HCC ReClaimTM – BDA has developed and is in the market as a subject matter expert in Hierarchical Condition Category (HCC) coding. We are offering an end-to-end solution that includes actionable information through a business intelligence solution, HCC ReClaim™.  The program reviews historic risk based claims (Medicare Advantage, ACOs, etc.) and identifies missing HCCs.  It tracks at the specialty level, practitioner level and patient level.  The goal is to optimize Risk Adjustment Factors (RAFs).  It is a sophisticated program that is supplemented by our training at the Practitioner level in regard to HCCs and specifically where we may identify documentation issues. https://billdunbar.com/bda-hcc-reclaim/

 

All of BDA's solutions offer comprehensive, customized, budget-neutral programs focused on developing and implementing growth strategies designed to improve clients' bottom lines. Before you engage BDA's services, we'll review your potential lost revenue opportunities — complimentary and at no obligation to you.  The BDA Preliminary Analysis, or Prelim, helps to identify your lost revenue growth opportunities for your fee-for-service and/or your value-based business.​



Additional resources: 

IHA Endorsed Business Partner Bill Dunbar and Associates (BDA) is providing IHA members with a free white paper on HCC Risk Adjustment.

BDA has developed and is in the market as a subject matter expert in medical documentation relating to Hierarchical Condition Category (HCC) Coding. They offer an end-to-end solution that includes a software program they call HCC ReClaim™https://billdunbar.com/bda-hcc-reclaim/ 

The program reviews historic risk based claims (Medicare Advantage, ACOs, etc.) and identifies missing HCCs.  It tracks at the specialty level, practitioner level and patient level.  The goal is to optimize Risk Adjustment Factors (RAFs).  It is a sophisticated program that is supplemented by their training at the Practitioner level in regard to HCCs and specifically where there might be identified documentation issues.

Contact Terri Scales at BDA (317-247-8014 or ts@billdunbar.com) for a demo and/or your free Preliminary Analysis.



Past Webinar:

An Overview of HCC Risk Adjustment, Documentation, and ICD-10-CM Coding

   Topics covered:
  • Overview of HCC Risk Adjustment for the CMS HCC Model
  • Factors that contribute to a patient’s risk adjustment  score
  • Diagnoses that CMS HCC Risk Adjust
  • Documentation to support diagnosis codes being reported
   Who should attend?
  • C-Suite Professionals, Outpatient CDI Specialists, Professional Coders and Billers, Providers, Ancillary Staff, Risk Adjustment Leaders, and HIM managers






​​SERVICES ENDORSED by IHA​​​​​: 

Outpatient CDI consulting with a focus on physician practices and emergency departments to ensure accurate documentation and coding for fee-for-service and value-based/HCC capture.​​


CONTACT:

David Dann, CEO/Partner
​Terri Scales, National Director of Business Development

2629 Waterfront Parkway East Drive, Suite 350
Indianapolis, IN 46214​​​
317-247-8014
http://billdunba​r.com