Compliance and Reimbursement Audits
Value of Compliance and Reimbursement Audits:
- Identifies revenue opportunities (underpayments)
- Ensure compliance (overpayments, non-compliance with coding guidelines)
- Identifies root causes of coding issues: coder error, physician documentation, workflow
- Coder feedback is reviewed and discussed prior to finalization
- Flexible scheduling without a resource commitment
- Detailed trend reporting, coder/provider education, solid recommendations
- Internal quality assurance ensures second level review of recommendations
- Work collaboratively with your team to ensure the process is efficient and organized
Types of audits:
- MS-DRG/CMS-DRG/AP-DRG
- APR-DRG
- Comprehensive Inpatient Coding Audits
- Outpatient Coding Audits
- Professional Fee/Physician-Based Audits – Evaluation & Management, Surgical Encounters
- Specialty Audits
Other Consulting Services
- Coder Education
- Provider Education
- Interim CDI Specialists
- Customized projects