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

• Identify, locate, review and interpret relevant medical records, hospital policies and procedures, other documents and tangible items.
• Organize, tab and paginate medical records for easy reference to the coding of the final bill.
• Prepare chronologies of the medical events involved in a case. Answer: is everything documented and coded properly?
• Summarize, translate and interpret medical records, as they related to coding, reimbursement and compliance.
• Identify issues of tampering with the medical records, or incomplete medical records, and missing physician orders – as these relate to reimbursement and compliance.
• Screen fraud and arbitration cases for merit.
• 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.
• Identify adherences to and deviations from these standards, including billing for too many or too few drug dosages, lab tests, etc.
• Develop written reports for the physician's, CFO's or attorney's use as study tools.

Supporting the Client's Case

• Search and summarize Medicare and reimbursement/compliance literature and integrate results of your search into your analysis.
• Analyze the validity of references relied on by all parties.
• Attend depositions, give testimony.
• Expand your clients’ reimbursement/compliance library.

Serving as the Physician's, CFO's and/or Attorney's Liaison

• Interview plaintiff and defense clients, key witnesses.
• Serve as an expert witness in legal and arbitration cases concerning coding, documentation, reimbursement and compliance cases.
• Consult with healthcare providers, financial managers and other attorneys on the case.
• Meet with other consultants and service providers on the client's behalf.

Working with Experts and Other Witnesses

• Identifying types of testifying experts needed for the case, utilizing the nursing and reimbursement expertise of other CRN-Cs if necessary.
• Find and communicate with appropriate expert witnesses for deposition and trial.
• Analyze potential experts' reports and other work product.
• Working with the client’s attorneys, help prepare witnesses and experts for deposition and trial.
• Serve as an expert witness and testify to the reimbursement and documentation issues at hand.

Assisting with Research, Discovery of  Pertinent Medical Records, and Preparing for Arbitration or Court

• Prepare questions for deposition or trial examination (direct or cross).
• Prepare interrogatories and requests for production.
• Review and draft responses to various legal documents and correspondence for the attorney's signature.
• Analyze and summarize depositions and past testimony.
• Assist with exhibit preparation and other demonstrative evidence.
• Attend courtroom proceedings when relevant.
• Coordinate and assist with facilitating focus groups and mock trials.
• Assist in resolution of cases through alternative dispute resolution, such as arbitration and mediation.