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Nassau University Medical Center Emergency Department Coding Services

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Posted:06-24-2014

RFP Title: Emergency Department Coding

RFP Category: Coding/Patient Billing/Revenue Cycle
RFP Sponsor: Nassau University Medical Center

Due Date: 2014-06-20

Contact Name: Teresa Silversmith
Contact E-mail: Tsilvers@numc.edu
Contact Phone: (516)572-3292

Description of RFP:

  • ED coding includes the Medical Emergency Room, Psychiatric Emergency Room and Labor and Delivery Emergency Room for the facility side and admissions from all three areas.
  • ED coding for the Physician side is solely for the Medical Emergency Room at the present time.
  • Vendor must be able to provide ICD-9 and CPT compliant coding along with accompanying modifiers, quantities and correct linkage between ICD-9 and CPT codes.
  • After October 1, 2015, vendor must be able to provide ICD-10 codes and CPT compliant coding along with accompanying modifiers, quantities and correct linkage between ICD-10 and CPT codes.
  • Vendor must be able to assign evaluation and management codes to all cases.
  • Vendor must be able to capture and provide various abstracted data as may be requested by NHCC.
  • Vendor must utilize only certified coders with specific expertise in professional and technical coding of emergency services.
  • Vendor must communicate with client for notification of incomplete documentation.
  • Vendor shall identify the names and years of experience of every coder assigned to the engagement prior to assignment. NHCC may order the removal of any coder, at any time, in its sole and absolute discretion.
  • Vendor must be able to apply special coding rules and guidelines set forth by the NHCC.
  • Vendor must check and verify all coding results against the National Correct Coding Initiative and any and all pertinent medical necessity rules.
  • Vendor must provide a statistical sampling of the quality of the coding process and provide agreed upon quality measures in a quality report that will be provided to NHCC on a monthly basis.
  • Vendor must maintain a coding accuracy measure of 95% or greater as measured by internal and external audits.
  • Vendor must agree to audit an agreeable percentage between vendor and NHCC of their coding and coding practices.
  • Vendor must hold and provide secure access to all medical record documentation for a minimum period of at least three (3) years, including access to all coding results information.
  • Vendor must provide all coding results within 48-hours of the submission of all information required by the vendor to perform the necessary coding.
  • Preference may be given to vendors that demonstrate experience performing comparable services for other hospitals located in the State of New York.
  • All data transfer, storage and sharing must be HIPAA compliant and also comply with the data security requirements below and such other reasonable requirements as NHCC may specify from time to time.

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