ReimBoost: Diagnoses Prioritization for Medical Coding

ReimBoost is a system for optimizing reimbursement for hospitals in England’s public healthcare system. We do this in three ways: 

1. Focus documentation improvement efforts on what matters for the financial stability 
2. We break down the important inputs for the resource grouping, which ultimately determines reimbursement, so hospitals and specialties alike know what inputs are especially important for them to consider and capture systemically within their remit. That is, your chief medical officer knows the most important codes across the spectrum, but your specialist knows the most important codes for resource utilization determination within their focus area.  
3. No more money left on the table 
4. Not every diagnosis code counts. Prioritize medical coding quality assurance to focus on instances where revenue is potentially being lost to ensure it is captured appropriately.  
5. For coders that primarily review admissions of a specific medical specialty, provide them with the same information that the specialist doctors are given. If the doctor knows it’s important to document and does so, but the clinical coder translating the documentation into procedure and diagnosis codes doesn’t and misses it, that’s revenue left on the table.  
6. Reduce administrative burden 
7. If you’ve reviewed the admissions that might have a significant financial impact, congratulations; you’re done! Increase department efficiency and productivity by eliminating review capacity that has no financial benefit.