Medical Coding Compliance Audits

Our medical coding audits are designed to maintain accurate, compliant and efficient coding processes for practices like yours.

Importance of Regular Coding Audits

Improves Claims Accuracy

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

1

Define Audit Goals

Determine the goals and scope of the audit. For example, improving coding and documentation, and detecting compliance issues.

2

Diverse Audit Team

Get 360⁰ perspective from a diverse team of experts such as certified coders, auditors, compliance, and clinical experts.

3

Conducting Audit

Conduct a thorough review of diagnosis and procedure codes, documentation, billing and collection processes and software/technology.

4

Documenting Findings

Provide well-documented audit findings, including coding errors, compliance issues and improvement areas.

5

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

Trusted partner for your medical coding audit and reviews

3%

or Less Initial Denial Rate

30%

Increase in Practice Collection

97%

Clean Claims on First Submission

98%

Net Collection Rate

85%

of A/R less than 30 days

Other Medical Billing & Coding Services

We streamline your charge entry process to reduce claims denial and low payments.

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.

Our efficient team handles different types of remittances with accuracy and speed.

Our claim submission process is designed to improve accuracy and reduce rejections.

We know each insurance company’s appeal process and know how to effectively appeal denials to get your claims paid.

We are experts at getting through to the insurance companies to dispute improper denials and slow payments.

Ready to Improve Your Coding Practices?