Wanda J Sutton Email and Phone Number

Hospice, Palliative, and Home Health CodingNetsmart EHR SuperUsermyUnity Home Health & Hospice platforms Analysis and evaluation of clinical documentation, ensuring documentation supports Hospice, Palliative, and Home Health diagnoses. Assignment of Home Health diagnoses based on the Patient-Driven Groupings Model implemented by CMS in 2020. Working collaboratively with the Interdisciplinary Team to follow-up on documentation requirements. Participating in department meetings, agency required in-service programs, and department Quality Assurance & Performance Improvement activities. Thorough understanding of ICD-10 Coding Guidelines and Conventions. Continual development of professional skills and knowledge. SuperUser for Netsmart myUnity & HomeCare EHRs, eClinicalWorks EMR, AllDocs Records Software, Solutions EMR, OnBase Data Base

Coordination of Palliative Care certification. Maintain health records through scanning and indexing of medical and legal documents for storage, classification, and retrieval of patient data using Solutions and OnBase software.

Query physicians & nurses for diagnoses to complete ICD-10-CM after Oct 2015 (ICD-9 prior to change over) coding for Certificates of Medical Necessity from CMS. Coding of services through CPT and HCPCS codes. Coordinate Medication Therapy Management program. Patient profile registration, insurance verification, and immunization records updating.

Assisted physicians and facilities in correcting closed & denied medical claims due to incorrect ICD-9, CPT, and HCPCS codes. Accepted offer by another company.

Registration and update of patient demographics in EHR. Insurance verification. Reviewed new patient medication information and contacted physicians for updated prescriptions. Company relocated to Texas.

Explored an interest in USP 797 Hood IV Compounding. Decided not to pursue IV compounding.

Prepared pharmacy prior authorization appeal cases for the Medical Review Committee. ICD-9 coding for prior authorizations. Notified patients of approval or denial according to CMS regulations. Peradigm Workspace/ Member Master /Sidewinder.

Accounts Receivable/Payable; Payroll & Benefits Management; Human Resources.

Assistant to Franchising Director of Southeast Division consisting of 13 states. Management of statistical reports for the Southeast Division of Franchising.

Outpatient Surgical Anesthesia and Pain Management Coding. ICD-9 Coding, claim submission, remittance, appeals, medical billing, and payment posting. A/R management and physician queries.

Internal Medicine Private Practice. Medical records, patient scheduling & registration, and insurance verification. E/M and SNF ICD-9 coding. Claim submission, third party follow-up, remittance processing, appeals, payment posting, and patient billing & collections, probate.