St Clair's mission is to provide consulting services and automated software systems to customers in the healthcare industry and to assure them a quality product and excellent services. It's vision is to be recognized in the industry as "The Standard" in providing quality and excellence in both products and services.
In pursuit of its healthcare mission and vision, St Clair performs the following comprehensive range of medical record services: inpatient (IP)/outpatient (OP)/physician practice coding reviews and associated educational services, medical record chart documentation reviews, admission "medical necessity" reviews, RAC "Medicare overpayment" reviews & appeals, Interventional Radiology (IR) coding/billing reviews, and contract coding-IP & OP. Also, St Clair performs charge description master (CDM) reviews.
With it's home office in Clearwater, Florida, St Clair has served more than 400 hospitals across the United States since 1991. During 15+ years of business, we have reviewed over 460 thousand claims and recommended more than fourteen (14) thousand coding/DRG changes in claims that recovered in excess of twenty four (24) million in lost revenues for our hospital clients.
St Clair provides detailed reports about any coding and/or billing changes that it recommends regardless of the revenue impact. Thus, you will have everything that you need to improve accuracy in your coding and billing operations, and comply with the applicable CMS regulations. With the advent of CMS's Recovery Audit Contractors (RACs) program which will soon begin to be implemented by four (4) national RACs in all states. St Clair is using it's physician consultants to assist hospital in reviewing in reviewing and appealing RAC determinations of Medicare overpayments. Beginning in 2007 during the RAC demonstration, St Clair Physician Consultants have attained considerable experience in handling such appeals with successful results for several Florida hospital clients.
In achieving its mission and vision objectives, St Clair relies on a dynamic group of board-certified physicians and AHIMA-credentialed HIM professionals to perform coding compliance reviews and CDM reviews for hospitals and physician practices. In performing these reviews, St. Clair consultants adhere to the requirements of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations. Our consultants have laptop computers which can be used to access the client’s MS-DRG & APG Grouper software, as well as its reference software for such up-to-date resources as: Coding Clinic and CPT Assistant. As the Project Director for our "coding & documentation" review engagements, Doyle Kenady, St. Clair President, oversees our assigned consultants, participates in the exit conferences/educational in-services, and assembles the draft and final review reports.
Apart from its medical record consulting services, under a 2003 marketing arrangement with MediData.med, Inc. (MediData- Dallas, TX), St. Clair sells its Medicaid Revenue Recovery Service (Service), which automates the Medicaid eligibility queries for a healthcare entity's applicable patient accounts. With this Service, a healthcare entity is able to significantly increase its Medicaid collections and significantly reduce its self-pay bad debt write offs and its accounts receivables.