Regular Audits to maintain High Compliance Standards
We realize approximately 40% of medical practice income is 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 an 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 in fraudulent practices. ICD-10-CM, ICD-10PCS, CPT, and HCPCS coding audits help organizations, 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 experts focus on compliant coding practices as well as on the accuracy and quality of coding and physician medical notes. With over +65 years of cumulative medical reimbursement expertise, having worked with physicians, acute care, critical access, ambulatory surgery, and FQHC 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.
Our team of credentialed audit experts helps healthcare organizations to mitigate risk and achieve compliance with in-depth assessments, reporting, and training. We perform comprehensive coding reviews and charge capture audits to identify any under and overbilling of services to improve overall billing accuracy and integrity. Our audit reports are customized to meet the specific needs of each client, The detailed reports identify error trends and convey performance improvement possibilities, by evaluating the strengths and weaknesses of your coding, documentation, billing, and reimbursement methodologies.