Keep Your Revenue
Cycle on Track

Leave your auditing and revenue recovery to the experts. From large-scale outsourcing to a professional opinion on your revenue process, our nationwide network of certified experts can help.

Get the Expertise You Need

Our highly trained auditors conduct more than 300,000 audits annually. Clients range from solo practitioners to large integrated health systems, academic medical centers, and payers. We match the expertise of each auditor by medical specialty and conduct multi-tier reviews on every audit to ensure your findings are accurate and save you time and money.

Medical Chart Reviews

Leave your auditing to the experts. Whether you are looking to completely outsource your needs or just need a second opinion, our nationwide network of credentialed auditors is here to help. We provide deep subject matter expertise in over 40 medical specialties to ensure your audits results are accurate and meaningful.

Auditing and Coding Support

Facility Chart Reviews

Our expert facility auditors deliver the accuracy you need to safeguard your bottom line. Our experts can identify specific areas of risk and provide support to your Clinical Documentation Improvement program.

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Risk Adjustment Reviews

Verify compliance and validate documentation and coding to avoid inaccurate risk adjustment or underpayments with an expert HCC audit. We utilize a structured methodology designed to validate the accuracy of diagnosis coding related to HCC categories and determine whether records meet CMS's compliance requirements.

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Professional Coding

We offer coding for any specialty. Our coding experience, coupled with our knowledge of all types of EMR vendors, will take your project from discovery to completion.

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Specialty Experts for Exceptional Accuracy

Expert coders for every specialty. Exceptional accuracy.

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    Independent Review Organization

    We work with a variety of government agencies and attorneys general throughout the country. If your organization is required to participate in a corporate integrity agreement, we can assist as your IRO (Independent Review Organization).

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    Special Investigations

    Validate the accuracy of audit findings for repayment requests. We reveal errors in the review to reduce your repayment amounts, identify issues with inaccurate physician documentation, and educate your providers so they can improve coding accuracy and claims processes.

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    Risk Adjustment Coding

    Incorrect coding could be costing your organization revenue. Our risk auditors are ensure all your diagnoses are coded to capture maximize RA scores.

Get More From Us

Experts for all of your organization's needs. Improve your revenue and eliminate risks.

  1. Search from numerous free, downloadable eBriefs that will answer your most challenging on-the-job questions related to coding and auditing.

  2. Watch this series of 30- and 60-minute on-demand presentations, delivered for free by our Audit Services team of thought leadership experts.

  3. Listen to the podcast series, Compliance Conversations, where they explore all things compliance, from providing telehealth services, to E/M coding risks.

  4. This series of auditing and coding best practice guides provide a straight-forward approach to solving complex issues, including modifiers and proper documentation rules.

We Offer Even More

We are a complete full-service partner for your organization today and tomorrow.

  1. Post Audit Education & Training

    Our flexible training is available on-site or remotely. We cover new provider training, post-audit education, and HCC training, as well as specialty training tailored for your organization.

  2. Charge Description Master Maintenance

    CDM updates and maintenance enrich the revenue cycle, improve financial forecasting, and certify data reliability and compliance. A fully maintained CDM is a necessity for every healthcare facility.

  3. Compliance Support Services

    From coding and auditing to training, we'll identify improvement opportunities and assist you in building a compliance plan that will improve your revenue and eliminate risks.

  4. Litigation Support/Expert Witness

    If your organization requires litigation support or expert witnesses relating to billing, coding, documentation or compliance issues, we have the subject matter expertise you need.

Frequently Asked Questions

Have a different question? Submit inquiries through our contact page.

Medical auditing is a review of a patient medical record to ensure documentation meets compliance requirements for medical necessity and coding accuracy.

The industry allows the use of either guideline. Both guidelines have pros and cons, it depends upon the nature of the presenting problem in which a patient is being seen by a healthcare provider. The best way to determine what is most advantageous is to compare the two versions.

For a baseline compliance audit, 10-15 patient charts is an industry-standard. For a focused audit, the sampling should increase to 10% of the eligible charts.

Risk Adjustment is a healthcare payment model that reimburses health plans that disproportionately attract higher-risk populations (patients) by transferring funds from lower-risk populations to higher risk populations. Both the insurance plans and physicians share in the risk for caring for patients, therefore both can participate in Risk Adjustment.

A score of 90% or higher is the most common threshold used to set the standard of performance by which organizations can measure and monitor coding accuracy.

See what a specialist can do for you.