Virtual CIO: Codetoolz, LLC

Dave Dowling is Virtual CIO for CodeToolz, LLC, a provider of Medicare procedure rate information to the medical industry.

What CodeToolz does (in their words):

Like any other business, physicians must ensure that their price is adequate to cover the cost to provide services and adequate compensation to the physician for their services and expertise. We are experts at analyzing contracts and fee schedules, securing the most optimal payer fee schedules. On average, our clients increase their revenue 2% – 7%.

What we do for CodeToolz

Dana Bellefountaine, CodeToolz‘s CEO, contacted us with millions of Medicare fee data records, and a vision for using that data to help physicians structure their fees so that they can avoid charging significantly more or less than they can be reimbursed by Medicare.  Every single medical procedure has a specific code, and a corresponding cost; and the fees can change multiple times during a year.  Imagine trying to keep track of all of that information!

Working with Dana, we developed a web app that allows physicians’ assistants to plug in a procedure code and determine the maximum allowable fee for that procedure.  This simple action can save physicians’ offices hundreds of thousands of dollars each year, dollars which would have been lost to Medicare in the form of underbilling.

Here’s a screenshot from the CodeToolz web app:

 

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