Outsource Medical Coding Audit Services to Prevent Revenue Leakage

Ensure the financial integrity and compliance of your healthcare practice with our expert medical coding audit services. By meticulously identifying and correcting coding errors, we ensure that you are accurately reimbursed for the services you provide, safeguarding against revenue loss and potential legal consequences.

Our team of seasoned professionals is equipped with the latest industry knowledge and tools to provide a comprehensive audit tailored to your specific needs. By partnering with us, you gain access to a wealth of expertise that not only enhances your coding accuracy but also optimizes your revenue cycle management. We understand the complexities of healthcare regulations and are committed to keeping your practice compliant and financially healthy. Trust in our services, and you’ll see a significant improvement in efficiency and peace of mind knowing that your practice is protected from costly errors and audits.

Enhancing the medical coding process is crucial for achieving positive results, and we are committed to delivering top-notch medical coding services with exceptional accuracy and dependability. Our team of certified medical coders and auditors brings extensive industry knowledge and expertise, enabling us to offer a wide array of comprehensive medical coding services tailored to healthcare providers across diverse specialties. By investing in the latest technology and ongoing training, we ensure that our team remains at the forefront of industry developments and regulatory changes.

This commitment to excellence means that healthcare providers can trust us to handle their coding needs efficiently, allowing them to focus on what truly matters—delivering high-quality patient care. Moreover, our streamlined processes minimize errors and reduce claim rejections, leading to quicker reimbursements and improved revenue cycles for our clients. Partnering with us not only enhances compliance but also promotes operational efficiency, ultimately contributing to better financial outcomes for healthcare practices. We invite you to experience the difference that precision and professionalism can make in your medical coding operations.

Our medical coding services feature a highly skilled team of AHIMA and AAPC certified experts who excel in the newest ICD-10 codes. No matter if you’re looking for FQHC, inpatient, outpatient medical coding, or HCC coding, we’re fully equipped to meet your needs. With our proprietary technology, we pinpoint errors, reduce compliance risks, boost quality assurance processes, and uncover financial opportunities to optimize your coding workflows.

Our Comprehensive Medical Coding Audit Services

• ICD-10 Coding Audits
• Coding Accuracy Audits
• Documentation Audits
• Healthcare Compliance Audits
• Risk Adjustment Audits
• Evaluation & Management (E/M) Audits
• Outpatient and Inpatient Coding Audits
• Revenue Cycle Management Audits
• Prospective Audits
• Retrospective Audits
• Charge Capture Audits
• DRG (Diagnosis-Related Group) Validation
• Modifier Usage Audits
• Medical Necessity Audits
• Coding Accuracy Evaluation
• Billing Compliance Audits
• Denial Management Audits
• Specialty-Specific Coding Audits
• Audit for Reimbursement Optimization
• Unbundling and Overcoding Detection
• Recovery Audit Contractor (RAC) Preparedness

Why Choose Our Medical Coding Audit Services?

– Comprehensive Audit Reports: Our audit reports are not just informational; they provide actionable insights and specific recommendations to correct coding inaccuracies. This hands-on approach helps healthcare practices enhance their coding accuracy systematically.

– Enhanced Compliance and Accuracy: Our audits thoroughly evaluate the precision of medical codes assigned to diagnoses, treatments, and procedures, ensuring alignment with stringent regulatory standards including ICD-10, CPT, and HCPCS codes.

– Preventive Measures Against Financial Discrepancies: Medical coding audits are crucial for identifying errors, inconsistencies, or potential areas of non-compliance that could lead to claim denials, underpayments, or severe legal repercussions.

Key Features of Our Medical Coding Audit Services:

In-depth Review of Current Coding Practices: We conduct a thorough assessment of your existing coding practices to identify critical focus areas, defining the scope of the audit based on your organizational needs.

Diverse Case Sampling: We select a representative sample of medical records, including Evaluation and Management (E&M) services, surgical procedures, and diagnostic tests, ensuring a comprehensive audit that covers various cases.

Verification Against Clinical Documentation: Our experts cross-check assigned codes against clinical documentation to verify accuracy, compliance with payer-specific guidelines, and adherence to national coding standards, including Medicare’s NCCI edits.

Identification of Common Coding Errors: We pinpoint typical coding errors such as upcoding, undercoding, or unbundling, documenting patterns that may lead to claim denials or compliance issues.

Regulatory Adherence: We ensure that coding adheres to industry regulations, including HIPAA, the Affordable Care Act (ACA), and guidelines from the Centers for Medicare & Medicaid Services (CMS), minimizing audit risks and legal penalties.

Actionable Recommendations and Detailed Reporting: Our detailed reports outline coding discrepancies and provide clear, actionable recommendations for error correction, ensuring that coding practices align with the latest ICD-10 and CPT code revisions.

Advanced Auditing Tools: Utilizing state-of-the-art medical coding auditing software and tools, such as 3M CodeFinder, Optum360 EncoderPro, and TruCode Encoder Essentials, we automate code validation processes, enhancing audit accuracy and efficiency.

Ongoing Support and Follow-Up Audits: We conduct follow-up medical claim audits to evaluate the implementation of recommended changes and continuously monitor long-term coding accuracy.

Our Facility Coding Capabilities

• Ambulatory Surgical Center Coding
• Inpatient Coding
• Outpatient Coding
• Diagnostic/Ancillary Coding
• Interventional Radiology Coding

Our Professional Fee Coding Capabilities

• Allergy & Immunology Coding
• Anesthesiology Coding
• Cardiology Coding
• Critical Care Coding
• Dermatology Coding
• Emergency Medicine Coding
• Endocrinology Coding
• Family Medicine Coding
• Gastroenterology Coding
• General Surgery Coding
• Infectious Disease Coding
• Internal Medicine Coding
• Nephrology Coding
• Obstetrics & Gynecology Coding
• Oncology Coding
• Orthopedic Coding
• Pain Management Coding
• Pathology Coding
• Pediatric Coding
• Physical Therapy Coding
• Plastic Surgery Coding
• Podiatry Coding
• Psychiatry Coding
• Radiology Coding
• Rheumatology Coding
• Urology Coding

Audit Findings for Decision-makers:

• Root Causes impacting Coding Quality and Claims Reimbursement
• Verification of ICD-10-CM Diagnosis Code assignment, including Principal and Secondary Diagnoses
• Verification of ICD-10-PCS and CPT Procedural Code assignments
• Verification of ICD-10-CM, CPT, Modifier, and Surgeon/Assistant Surgeon code assignments
• Prioritization of Financial Impacts based on Coding Quality
• Medical Coding and Provider Documentation Educational Opportunities
• Verification of coding accuracy for medical necessity
• HCC log and Educational Opportunities

Most Common Specialties Audited

• Orthopedics, Rheumatology, & Physical Therapy
• Dermatology & Plastic Surgery
• Cardiology, Vascular, & Pulmonary
• Urology, Oncology, OB/GYN
• Ophthalmology, ENT, & Neuro
• Internal Medicine, Family Practice, & Urgent Care
• Adult & Pediatric
• General Pediatrics & Pediatric Subspecialties

Optimize Your Medical Coding Practices

By outsourcing your medical coding audits to us, you gain a partner dedicated to maximizing your reimbursement opportunities while maintaining compliance with evolving healthcare regulations. Contact us today to safeguard your practice against revenue leakage and position yourself for financial success and stability.

Request Free Quote on info@medicalbillingindia.com