Jim Tudor Email and Phone Number

Provide subject matter expertise in the realm of billing and coding as it pertains to payor audits and related litigation. Perform detailed analysis of audit results and offer recommendations as to the viability for appeal. Preparation of formal responses, appeal letters, exhibits, etc. Assist with settlement negotiation process.

JTCPC provides a wide range services, including chart review for audit and documentation improvement, result based and general education, provider coaching/shadowing, and much more. With experience across many specialties, JTCPC can effectively convey complex coding rules and CMS regulations to your providers in a straightforward, respectful fashion. Areas of specialty interest include:Hospitalist / Internal MedicineAdult & Pediatric Primary CareEmergency MedicineHematology/OncologyCardiopulmonaryOrthopedicsDermatologyNeurology Obstetrics & GynecologyGeneral SurgeryEndocrinologyAreas of expertise include:Evaluation & Management (E/M) ICD-10Teaching Physician"Incident To" & Split/Shared VisitsMedicare Advantage / HCC CodingMS-DRG and OPPSJTCPC also offers effective, affordable solutions to your data management needs. As an MS Access/VBA programmer, JTCPC can design and implement a customized Access database application unique to your organizations Audit Plan or Billing Compliance processes. Contact Info:James M. Tudor, CPC, PCAJTudorCPC@Gmail.com603-701-2320 (home office)978-413-1130 (cell)

Oversight of all due diligence chart audit programs and provider education with regard to coding and billing compliance. Create and monitor audit plan to ensure expedient turnaround of deliverables. Management of coding team and consultants involved with all billing compliance initiatives. Assist various law firms with the evaluation and potential appeal of cases in which alleged inaccurate billing results in an overpayment and/or extrapolation.

Manage team of outpatient (pro and facility) coding educators and clinical documentation improvement (CDI) team for a 269 bed acute care facility with associated 350 provider group practice; write internal policies/procedures/job aids, administer pro fee and facility auditing and monitoring programs. Design and implement ICD10 education plans, dual coding, and quality reviews.Highlights: Created and implemented provider audit and education plan, coder audit and education plans Mitigation of risk through effective provider education, close collaboration with compliance department, revenue cycle team. Identify documentation improvement and revenue opportunities  Manage clinical documentation improvement (CDI) team, monitor CMI, APR-DRG ROM/SOI, length of stay Creation and oversight of coder auditing and education plan Administer ICD-10 dual coding and educational initiatives Review queries for accuracy and compliance Monitor workqueues/DNFB attributable to quality reviews Administer audit software (MD Audit) and MS Access database (personally designed and implemented) Analyze billing distribution /financial reports, report periodically to senior physician leadership and key administrators ICD10 training/optimization/EMR remediation (Epic).  Serve on several committees, including physician advisory, revenue cycle, ICD-10 optimization.

Manage team of outpatient (pro and facility) coding educators and clinical documentation improvement (CDI) team for a 269 bed acute care facility with associated 350 provider group practice; write internal policies/procedures/job aids, administer pro fee and facility auditing and monitoring programs. Design and implement ICD10 education plans, dual coding, and quality reviews.Highlights: Created and implemented provider audit and education plan, coder audit and education plans Mitigation of risk through effective provider education, close collaboration with compliance department, revenue cycle team. Identify documentation improvement and revenue opportunities  Manage clinical documentation improvement (CDI) team, monitor CMI, APR-DRG ROM/SOI, length of stay Creation and oversight of coder auditing and education plan Administer ICD-10 dual coding and educational initiatives Review queries for accuracy and compliance Monitor workqueues/DNFB attributable to quality reviews Administer audit software (MD Audit) and MS Access database (personally designed and implemented) Analyze billing distribution /financial reports, report periodically to senior physician leadership and key administrators ICD10 training/optimization/EMR remediation (Epic).  Serve on several committees, including physician advisory, revenue cycle, ICD-10 optimization.