32 Services You Can Provide as a Certified RN-Coder
As a CRN-C you can apply your knowledge and understanding of medical, nursing
and reimbursement/compliance-related issues to make the physician’s, CFO/financial
manager’s or attorney's job easier, more efficient and more effective.
You are a medical insider who knows the inner workings of our complicated healthcare
system firsthand. Your professional expertise as an RN and a CRN-C® qualifies you to
provide the following services:
Assessing Medical Records and Analyzing Payment Reconciliation
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Identify, locate, review and interpret relevant medical records, hospital policies
and procedures, other documents and tangible items.
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Organize, tab and paginate medical records for easy reference to the coding of the
final bill.
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Prepare chronologies of the medical events involved in a case. Answer: is
everything documented and coded properly?
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Summarize, translate and interpret medical records, as they related to
coding, reimbursement and compliance.
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Identify issues of tampering with the medical records, or incomplete medical records,
and missing physician orders – as these relate to reimbursement and compliance.
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Screen fraud and arbitration cases for merit.
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Identify, locate, summarize and interpret applicable standards of care, and
identify “unbundled” nursing services, lab, and other ancillaries that may or may
not be separately billed.
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Identify adherences to and deviations from these standards, including billing for too many or too few drug dosages, lab tests, etc.
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Develop written reports for the physician's, CFO's or attorney's use as study tools.
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Supporting the Client's Case
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Search and summarize Medicare and reimbursement/compliance literature and
integrate results of your search into your analysis.
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Analyze the validity of references relied on by all parties.
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Attend depositions, give testimony.
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Expand your clients’ reimbursement/compliance library.
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Serving as the Physician's, CFO's and/or Attorney's Liaison
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Interview plaintiff and defense clients, key witnesses.
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Serve as an expert witness in legal and arbitration cases concerning
coding, documentation, reimbursement and compliance cases.
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Consult with healthcare providers, financial managers and other attorneys on the case.
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Meet with other consultants and service providers on the client's behalf.
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Working with Experts and Other Witnesses
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Identifying types of testifying experts needed for the case, utilizing the
nursing and reimbursement expertise of other CRN-Cs if necessary.
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Find and communicate with appropriate expert witnesses for deposition and trial.
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Analyze potential experts' reports and other work product.
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Working with the client’s attorneys, help prepare witnesses and experts for
deposition and trial.
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Serve as an expert witness and testify to the reimbursement and documentation issues at hand.
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Assisting with Research, Discovery of Pertinent Medical Records, and Preparing for
Arbitration or Court
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Prepare questions for deposition or trial examination (direct or cross).
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Prepare interrogatories and requests for production.
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Review and draft responses to various legal documents and correspondence
for the attorney's signature.
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Analyze and summarize depositions and past testimony.
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Assist with exhibit preparation and other demonstrative evidence.
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Attend courtroom proceedings when relevant.
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Coordinate and assist with facilitating focus groups and mock trials.
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Assist in resolution of cases through alternative dispute resolution, such as
arbitration and mediation.
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