Ambulatory Payment Classification (APC) Pricing
Pre- and Post Pay Outpatient Claims
HealthMind provides several types of pricing services including a fully integrated pre- and post-pay APC pricing. The service is delivered through our new delivery platform ReThink™, which is built on a continuous looped architecture with dynamic discovery. As a result, we are able to dig much deeper into all coding rules to ensure maximum compliance and payment accuracy.
A VALUABLE SERVICE
With more services being performed on an outpatient basis, APC pricing is becoming increasingly more valuable. Many vendors cannot provide cost effective APC pricing because there is no single source for validating claims. ReThink™ utilizes CMS raw data tables and has integrated the rules and edits, as well as additional fee schedules into one seamless system eliminating errors and providing complete and accurate outpatient pricing. Utilizing the CMS raw data tables in ReThink™ allows for updates to the APC pricer within 24-48 hours of updated tables being released from CMS.
How it works:
- Developed by our team of IT specialists in collaboration with our coding and clinical experts
- Offered through a fully integrated pre-and post-pay platform
- Eliminates pricing errors
- Incorporates necessary outpatient fee schedules (Lab, DME, Physician and ASP)
- Provides a compelling and easy to understand ROI