PwC's SMART Inpatient tool is your coding compliance quality solution

More than 300 hospitals nationwide use SMART to mitigate their risk. Can you afford not to be one of them?

PwC’s SMART tool helps hospitals analyze coding quality, correct coding errors before bills are submitted, identify process improvement opportunities to reduce reimbursement risks, and measure outcomes against key performance indicators. This automated tool also helps health information managers monitor and analyze the root causes of underpayment and overpayments to correct these errors and create a culture of compliance aimed at improving financial stability, compliance, and clinical quality. SMART yields benefits in the following functional areas:

Health Information Management

  • Identifies and tracks case mix, length of stay, and ancillary operational trends
  • Identifies issues related to MS-DRGs, post acute care transfer DRGs, present-on-admission coding, illness severity score, and APC and HCPCS codes
  • Provides ability to analyze 100% of coding and claims data from HIM. For outpatient services, also analyzes post-scrubbed billing data, with HIM data identifying potential discrepancies
  • Strengthens coding supervision by serving as a feedback mechanism that identifies areas for focused coding, departmental, and physician education
  • Simplifies the coding evaluation process, aligning data reports with trends and providing methods for coder education and documentation improvement

Revenue Cycle Operations

  • Results in fewer denied or suspended claims
  • Lowers resource utilization
  • Reduces the number of days in accounts receivable
  • Provides strong reporting tools
  • Improves departmental communication
  • Increases cash flow

Corporate Compliance

  • Identifies topics for compliance education and training (both hospital and physician)
  • Monitors and documents ongoing compliance with Medicare coding regulations
  • Provides audits and reviews of areas identified in the OIG annual work plan

Internal Audit

  • Provides a database with ability to drill down for further analysis
  • Identifies and addresses trends
  • Provides target reviews

Subject matter specialist

Eileen Murphy

US Healthcare Provider Practice

Show details Eileen Murphy