New company aims to maximize reimbursements for eye care

San Bernardino, CA-A new company has been created to help ophthalmologists and optometrists improve the accuracy of the coding they do on claims they submit for reimbursement for the services they provide.

The Corcoran Consulting Group has launched Corcoran Compliance Connection LLC to provide real-time coding recommendations based on chart documentation in medical practices’ electronic health record (EHR) systems. A practice’s EHR is linked to company software to accomplish the task.

“Our clients tell us that coding software of current [EHR] programs [is] unreliable and difficult to use,” said Kevin J. Corcoran, a co-owner of the consultant company. The new company, he added, analyzes claims using algorithms derived from the consulting group’s 25 years of experience.

Despite the fact that EHR systems can automatically assign codes for evaluation/management services, 88% of physicians participating in the Medicare program assigned codes manually in 2011, according to Corcoran, citing a June 21 report by the deputy inspector general for the U.S. Department of Health and Human Services’ Office of Inspector General. The remaining 12% had codes assigned manually by professional coders on staff, the report said.

“Clearly, there is an enormous unmet need for a trustworthy and reliable expert coding and compliance system to support physicians,” Corcoran said.

Coding for eye exams is accurate and supported by the medical record in only 60% to 70% of all office visits, according to Suzanne L. Corcoran, co-owner of the consulting company.

“The 30% to 40% of claims for reimbursement of office visits that are not coded correctly or not supported by the chart notes pose a challenge for the practice,” she added.

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