Accurate and complete clinical documentation and coded data is necessary to demonstrate a health service’s casemix (activity mix) and ensure correct and legitimate reimbursement for the care provided. It is also important that accurate coded data is generated as it is also used for: quality of care and patient safety, clinical research, clinical management, workforce and facilities planning, setting benchmarks, monitoring identifying epidemiological patterns and disease trends, and making comparisons between health services, areas and states. Clinical Coding Services (CCS) can help ensure your coded data is accurate and your revenue is correct for the services provided:

  • For health services – to ensure your coded data accurately reflects your casemix and to identify any missed revenue opportunities
  • For funders – to ensure you are paying only for services provided as described by the submitted coded data.

Contact Andrea Groom to discuss how we can help support your organisation’s requirements:

Andrea Groom, Health Information Consultant / Director
0418 129 543
PO Box 5273, Pinewood, Victoria, 3149

CCS Services Available

  • Auditing services:
    • Clinical coding and casemix/DRG audits
      • Random
      • Targetted
    • Clinical documentation improvement audits
    • Admitted patient data item audits
    • MBS (Medicare Benefit Schedule) item number audits
    • Prosthesis List billing code audits
    • Invoice/billing audits
    • Audit results reporting, including identification of process issues, training requirements, resource issues and classification of error types, causes, impacts and recommendations
  • Training/education/coaching/mentoring (one-on-one or as a group, customised to your health service’s casemix) for coders in
    • Clinical coding and classification
    • Coding audit
    • Coding and coding audit processes
    • Casemix and funding models
    • Clinical documentation improvement to empower coders to identify conditions (not sufficiently documented to allow codes to be assigned) and develop high quality and ethical documentation queries
  • Review of health service’s clinical coding services
  • Casemix/DRG analysis and reporting
  • Clinical documentation improvement – implementation of a new CDI program or review and improvement of your current CDI processes
  • Casemix, funding model and documentation education, for clinicians, business managers, health service management, others.

Services are available on-site or remotely, even if your health service does not have an electronic or scanned medical record – ask us how!

About CCS

CCS was established in 1999 by Andrea Groom. Since 2010, CCS is a privately owned company with Andrea Groom as the Director and Health Information Consultant.

CCS has a team of very experienced Health Information Managers/Clinical Coders to assist with your project. All of the team have more than five years’ coding experience (with the majority having significantly more than five years’ experience) and have worked as coders, coding managers, coding educators and coding/documentation auditors for major health services (public and private). Our work across all States/Territories of Australia and in small to large health services means we have experience in many different systems (PAS, EMR/SMR) and are aware of the nuances of different State/Territory coding advice. Further, most of the team are, or have been, members of the Victorian ICD Coding Committee, the Victorian Department of Health & Human Services statewide (VAED) clinical coding audit team, hold a Certificate of External and Internal Clinical Coding Auditing (La Trobe University) and are Certified HIMs/CCs (CHIM/CHIP) (HIMAA).

Andrea has more than 40 years’ experience in health information management, specifically in the field of coding and casemix in acute health and has been involved in the development of the Australian coding and DRG systems. Andrea has also provided input into national coding quality tools and changes to statewide public health service admission policies. Further, Andrea has extensive experience in audits of coding, billing, clinical documentation, casemix and related data items and in coding and casemix education to coders, clinicians, and administrators. Andrea is actively involved in all projects and takes personal responsibility for the quality of every project.

Our multiple repeat projects are an indication of our success in the field and we can provide contact details of our many happy clients.