We realize approximately 40% of medical practice income are unpaid due to down coding, missed charges, or not reimbursable. 25% of chart audits uncover coding errors resulting in non-payment. This can result in inspection by payors such as Medicare and result in your practice being audited for over coding and for down coding of services. Both can result as a fraudulent practice. ICD-10-CM and CPT coding audits help physicians and medical practitioners of all sizes to appropriately assign procedure codes, reduce over coding and down coding liability, and cushion insurance payors denials and suspensions.
Our certified coding audit staff focuses on compliant coding practices as well as on accuracy and quality of coding and physician medical notes. Our dedicate team consists of certified professional coders who bring the most value to your facility. With over +65 years of cumulative medical reimbursement expertise, having worked with physician, medical billing entities, payers both federal and commercial, county clinics and specialty service providers our experts offer a unique external perspective to the physicians and medical professional with respect to current billing, coding and documentation practices.
Medical notes by the provider are reviewed to determine that the levels of services about to be billed are supported by the providers chart note or dictation. Appropriate use of CPT and HCPCS Modifiers is also reviewed. Upon the conclusion of the coding review and audit, Medical coding team provides post-assessment reports for the practice and for each individual provider with recommendations. Also, a general education session is provided for all providers and each provider receives an individualized educational session to discuss the particulars of their own audit. Our chart review process follows a designed methodology to identify improvement opportunities through a comprehensive assessment of medical notes, coding, and billing. This approach identifies gaps between existing processes and national best practices: We specialize in all aspects of professional coding audits.
Proudly Offering the Following Services
Coding and Billing Audits
Medical Coding service
Onsite coding service
Remote coding service
Revenue Cycle Management
Pre-billing Edit Reviews
Medical notes Improvement Consultations
HCC and HEDIS coding and review
Talk to us today to discuss how our coding and documentation audits could benefit your practice.
REMOTE CODING SERVICES
A cost effective and convenient remote coding service from us is to meet your coding difficulties. We provide you a team of experienced coding staff suited to your medical specialties need and requirement.
Our remote coding services include the following deliverables
Cost-effective and Efficient remote coding services
High $$ Equipment and Hardware for scanning
Technician to scan encounters and medical notes
Quality assurance ensuring 95% DRG accuracy for inpatient discharge summary
Inpatient discharge summary coded within 24 hours after records are sent
Certified and experienced remote coding professionals
Expert and professional management team
Our certified coders will adhere to CMS regulations, government policies and DRG optimization techniques. Medical coding professionals apply ICD-10-CM coding conventions, official ICD-10-CM coding guidelines.
Our certified coding experts have a minimum of +6 years of experience in inpatient facility (DRG) coding. Our coders are certified with one or a combination of the following credentials: RHIA, RHIT and/or CCS. We depute a specialty specific team of medical coder that fits your medical center.
ANCILLARY HEALTHCARE SERVICES
To facilitate healthcare entities we provide wide range of ancillary services adhering to guidelines determined by commercial and federal payers and hospitals. We monitor these guidelines on behalf of your clients to ensure medical provider’s files remain accurate and up to date. Our services includes the following for healthcare providers and allied healthcare professionals.
CAQH / Provider portal
Allied Health Database
Fee schedule negotiation
Clearing house / EDI and EFT setup
Our objective is to improve the quality and efficiency of clients reimbursement process. We have strong relationships with managed care plans, hospitals, and related organizations that increase in value of our expertise and relevance in streamlining the process.