The Wellington Group, LLC
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Case Mix Explorer™
Revenue Cycle, Coding and Documentation
Case Mix Explorer™ (Explorer) is a web-based, interactive dashboard that monitors case mix and related performance indicators as well as identifying coding and CDI issues that may affect case mix. Using your hospital data, collected on a daily basis, Explorer monitors performance on a monthly and year-to-date basis. Drilldown reports identify the DRG, DRG cluster, physician or service driving changes in performance, which will be crucial for coding, documentation and financial staff during the transition to ICD-10.
Automating the Audit/Appeal
Workflow, Tracking and
AuditNavigator™ is the next generation system to move from just tracking to automating many of the manual processes previously performed by your staff. AuditNavigator™ gathers information from RAC websites, the FISS system, remittance files, etc. and using information to automatically enter new audits as well as updating financial information and status of existing audits. Your medical record information can be electronically retrieved from your EHR system and subsequently formatted and electronically submitted. Automating these processes frees up staff time for other needs and reduces costs.