Coding Quality and Audit Services
Medical coding compliance and audit services for hospitals, health systems, and physician practices that want to mitigate risk by achieving and maintaining regulatory coding compliance.
Reduce Coding Compliance Risk
Achieve coding accuracy at the highest level to help prevent missed revenue opportunities.
Meet compliance obligations and receive recommendations to help you achieve desired coding outcomes.
Identify under or overbilling of services from comprehensive reviews and charge capture audits.
Optimize front-end and back-end billing processes to help streamline operations and improve overall billing integrity.
Ensure appropriate billing for documented procedures to help mitigate risk.
Uncover trends and identify opportunities for improvement to achieve financial and data-quality goals.
Audit Services to Help Mitigate Risk and Gain Compliance
Support across all care settings
- Access a variety of third-party compliance and auditing services, including coding compliance, provider documentation, and reimbursement audits.
- Our expert compliance team stays current on regulatory changes so we can help you stay in regulatory compliance and mitigate risk. We can also help develop compliance plans or assess ones already in place.
- Our credentialed professionals perform comprehensive reviews and charge capture audits to identity any under and overbilling of services to improve overall billing accuracy and integrity.
Compliance and auditing expertise
- Our team of experts help organizations of all sizes mitigate risk and achieve compliance with in-depth assessments, reporting, and training. Each of our auditors has multiple credentials, including CCS, CCS-P, CDIP, RHIA, RHIT, CPC, and COC.
- We can help your team establish best-practice coding and documentation compliance standards. Our team can also help you develop processes for auditing and confidential reporting, including enforcement, response, and prevention guidelines.
- We can review and evaluate the groups or individuals responsible for monitoring, tracking, and reporting charges to identify deficiencies in code and modifier assignments and to identify opportunities for improvement.
Provider education and training
- Educating and training staff is essential to improving your processes. Our customized training services use your specific audit results and can be delivered onsite or via webinars.
- Our provider education services are designed to optimize front-end and back-end billing processes. These services are offered on an annual and ad hoc basis as necessary.
- Based on your audit results, education and training sessions may include the following topics: Evaluation and Management, Surgical and Specialty Coding, Documentation Improvement, and ICD-10-CM Diagnosis.
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INFOGRAPHIC
When it Comes to Coding, Accuracy Matters
Infographic on coding challenges and best practices for hospitals, health systems, and physician practices.