Coding Services & Reviews
Medical coding is a key activity that impacts the financial health of your practice/company. Inaccurate or incomplete coding can cost the average physician thousands of dollars per year in lost revenue or delayed payments. Without specialized expertise, focus and an infrastructure to support the process, you are only increasing your exposure to risk.
Our team of medical billing coders are AAPC certified and are proficient in ICD-10, CPT, and HCPCS codes and standards, insurance and governmental regulatory requirements, and payer-specific coding guidelines and requirements. Our certified medical coders (CPCs) are knowledgeable about the constantly-changing trends in diverse healthcare specialties and educate our clients on use of accurate codes and modifiers to get your claims accepted on the first submission.
Coding Reviews & Audits
The goal of a coding audit is to provide efficient and better delivery of care and to improve the financial health of the medical provider. Medical record and coding audits specifically target and evaluate procedural and diagnosis code selection as determined by physician documentation, with special emphasis on unbundling, up-coding and down-coding. Once areas of weakness are revealed through an audit, our team of certified coders can present the audit findings, identify opportunities for education in your health care organization, and provide training for providers and staff.
ICD-10 Training & Education
The introduction of ICD-10 has caused a staggering amount of insurance denials. While many providers received training in the initial roll-out, applying that knowledge has proved challenging in the day-to-day application to coding and billing of charges. Our team of ICD-10 certified coders can assist with the continuing education of providers and staff with diagnosis coding and coding selection guidelines. We also offer specialty specific education focusing on the unique set of codes that have the greatest impact on you.
Accurate coding is critical from a compliance standpoint, but impacts reimbursement as well as how long it takes to collect dollars for services rendered. Inaccurate coding can lead to lengthy appeals which increase your days in accounts receivable and impacts your cash flow. Our team of certified coders can offer training in Evaluation and Management guidelines, documentation and level selection in both the outpatient and inpatient settings, and physician training in the proper use of HCPCS Modifiers with emphasis on the most frequently used modifiers.
wRVU Reporting & Bell Curve Analysis
More and more entities are using the wRVU model of reimbursement for employed physicians. Our team of certified coders can assist with the capture of wRVU adjustments due to MPPR (Medicare Multiple Procedure Payment Reductions) and decreases due to HCPCS modifier adjustments.
Through the use of a bell curve analysis, E&M utilization data can easily identify providers that may be considered outliers compared to their peers. This data identifies providers who are potentially undercoding or overcoding. This is the same data that CMS and other payers are reviewing to determine whom they wish to audit.