3M™ 360 Encompass™ Audit Expert System – Inpatient Prebill Review

Integrated within the 3M 360 Encompass System workflow, Inpatient Prebill Review gives coders the means to resolve potential issues early on, keeping small issues from becoming large ones.

Inpatient Prebill Review’s actionable edits address coding pain points that align with an organization’s coding policies and procedures. These edits provide coders with guidance and education as they are coding, so they can correct issues before they become problems. Actionable edits that are used during a coding session are also recorded for tracking, trending, routing and reporting purposes.

The Inpatient Prebill Review workflow supports edit-driven second level reviews, or additional reviews as specified. It is integrated within 3M 360 Encompass and includes:
 

• Communication tools for reviewers and coders
• Visual indicator of suggested changes
• Information tracked for further reporting

To send accurate, clean and complete claims to Medicare and other payers, compliance professionals and HIM departments can make a real difference by implementing these key strategies when complying with coding rules and guidelines:
 

• Detection: identify actionable edits at the point of coding
• Correction: develop coding and review processes that fix potential issues early in the workflow
• Prevention: educate staff to prevent errors while at the point of coding
• Verification comparison: track and monitor coding performance