Aristo’s coding compliance program is an integral part of our corporate compliance program. Our coding compliance program provides the necessary guidelines to address complex coding and billing issues. It is continually evaluated and re-evaluated to ensure effectiveness. It is understood that rules will change, new reimbursement methodologies will be adopted, codes will change, new laws will be enacted, and there will be employee turnover. 

Aristo uses a compliance scorecard method to assess the effectiveness of our compliance plan. The scorecard measures specific processes and serves as a motivational tool for employees and managers. Some scorecard items from our coding compliance department includes the following: 

​

• Coding accuracy goal of 98% while maintaining greater than a 95% accuracy rate 

• Monitoring and providing group feedback on downcodes 

• Reduction in billing/claim errors (measured as a percent of total claims billed) 

• 100% participation in coding and documentation educational programs 

 

Our expected results of the coding compliance program, along with dedicated educational efforts, will be that coding will improve over time, documentation will support the medical necessity of charges, denial rates and physician queries will decline, and all employees will have received the training they need to perform their job responsibilities in a compliant manner. To ensure we reach our program goals, we effectively manage our program with operational policies and procedures that are owned and adopted by all employees. 

​

Aristo utilizes certified coders who are trained and held to Aristo’s internal coding standards. Our training, QA process, and auditing ensures our emergency department coders are able to capture accurate charge information from the medical record. Using our proprietary coding platform, we are able to code efficiently and effectively. The software offers downcode reporting at the patient, physician, and location level, as well as data that can be used for provider documentation training and education. We measure and monitor each step with internal and external audits as a part of our compliance process.  

​

• Automated Processes: Secure transfer files for patient demographics and chart downloads into Aristo’s proprietary coding platform.  

• Coding Team: Aristo’s coding team codes charts directly in our secure coding platform within 24-48 hours with attention to accuracy, efficiency, and provider feedback.  

• Provider Documentation Education and Training: Downcode reporting is provided at the patient and provider level with coding element details and the financial impact at the provider and group level. Documentation training and education for group and individual providers are available on-site, via conference calls, or one-on-one training. Training is provided by certified coders, certified auditors, and physicians.

• Corporate Compliance Programs: Monitoring of the group’s revenue and compliance environment for conformity with industry standards. Detailed reporting and audits provide downcodes, documentation education, follow-up training, risk identification, and opportunities for improvement which ensures effective communications 

• Chart Audits: Internal and external audits are conducted to monitor coding and compliance. Applicable feedback is provided to the provider group and to the coding team with opportunities for improvement.  

• Charge Export: Charges are exported electronically from the coding platform into our GE Practice Management system which eliminates charge entry manual errors. Claims are electronically submitted to payers within 24 hours.