Identification and correction of coding errors such as wrong procedure or diagnosis codes can significantly impact claim accuracy.
Eliminate Undercoding and Overcoding
Identify patterns of undercoding and overcoding. Undercoding results in revenue loss, overcoding can lead to legal repercussions.
Continuous improvement
Audit findings offer valuable feedback for improvement that can be used for implementing training programs and updating coding practices for your staff.
Documentation Quality
Get insights into the quality of your documentation, including medical records, physician notes, reports, etc. By detecting and correcting document errors, you can increase your clean claim ratio.
Reduces Compliance Risk
Regular audits will ensure that your claims adhere to regulations such as Health Insurance Portability and Accountability Act (HIPAA), Affordable Care Act (ACA) and other guidelines.
Our Medical Coding Audit &
Review Approach
Define Audit Goals
Determine the goals and scope of the audit. For example, improving coding and documentation, and detecting compliance issues.
Diverse Audit Team
Get 360⁰ perspective from a diverse team of experts such as certified coders, auditors, compliance, and clinical experts.
Conducting Audit
Conduct a thorough review of diagnosis and procedure codes, documentation, billing and collection processes and software/technology.
Documenting Findings
Provide well-documented audit findings, including coding errors, compliance issues and improvement areas.
Corrective Action
Develop a roadmap based on the findings, including improving coding processes, changes to documentation practices, software/technology or additional training for staff, etc.
What our customer say
In the aftermath of the first audit and subsequent financial meeting, our group experienced a pleasant surprise with the discovery of an additional revenue stream. The meticulous approach taken by Medetec included providing point-by-point comments on billing errors, predominantly highlighting instances of under billing that had persisted for years. This level of insight and attention to detail has had a direct and positive impact on our financial outcomes.
Trusted partner for your medical
coding audit and reviews
We provide your patients with the best possible customer service to answer their questions, interpret their EOBs, and work with their insurance companies to get their claims resolved.