AAPC specializes in healthcare reimbursement. We know the regulations and guidelines governing medical billing and coding. We also know the cost of error, which can exceed tens of millions of dollars. As the leading credentialing organization of healthcare information management professionals, we set the standards for expertise. Should you need that expertise in relation to litigation of alleged improper billing and coding, we can ensure you receive accurate and trustworthy litigation support.
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With extended experience across multiple places of service, our medical billing experts possess master-level proficiency in ICD-10-CM and -PCS, CPT, and HCPCS Level II — as well as the methodologies that link these code sets to APCs, MS-DRGs, and MS-LTC-DRGs. Their medical specialty experience is equally diverse, ranging from pediatrics and behavioral health to anesthesiology and level 2 trauma. Cases in which they’ve provided litigation support include:
Medical necessity (based on chart review)
Healthcare fraud
Qui tam actions
Overbilling and concealment
Payer/provider disputes
In meeting trial evidentiary standards, our expert witnesses have been qualified through knowledge, skill, practical experience, training, and education. Below is a partial list of credentials held by our three litigation support experts.
CPC — Certified Professional Coder
CPC-I — Certified Professional Coder, Instructor
CIC — Certified Inpatient Coder
CCS — Certified Coding Specialist
CCS-P — Certified Coding Specialist, Physician
CICA — Inpatient Coding Auditor, HFMA
COC — Certified Outpatient Coder
Approved ICD-10-CM/PCS Trainer
CEMC — Certified Evaluation and Management Coder
CFPC — Certified Family Practice Coder
CDIP — Certified Documentation Improvement Practitioner
RCC — Radiology Coding Certification Board
CPC-H — Certified Professional Coder, Hospital
CPCO — Certified Professional Compliance Officer
CHCO — Certified Healthcare Compliance Officer, Healthcare Compliance Resources
CPAR — Certified Patient Account Representative
CRCR — Certified Revenue Cycle Representative
CPHM — Certified Professional Healthcare Management
ACS-OP — Ambulatory Care Center, Outpatient
FCS — Flexible Compensation Specialist
CPMA — Certified Professional Medical Auditor
RMC — Association of Registered Healthcare Professionals