Medical Review and Coding

Our staff experience includes both Part A and Part B Medicare administration. Whether you need assistance with coding backlogs or performing coding audits, our staff is knowledgeable with ICD-9, CPT, and HCPCS coding.


Incomplete medical records have devastating negative financial impacts on hospitals every year. We recommend a proactive approach to ensure each medical record is properly documented with appropriate physician signatures. Our RN reviewer assists clients with medical review audits to ensure proper coding and medical record documentation.

Revenue Recovery Audits

During our revenue recovery audits, we review your patient records for “lost” revenue. Issues identified include inappropriate denials, charge write-off errors, MSP corrections, inaccurate patient registration information, and unbilled claims or services.

 

Effective in 2007, Medicare HMO claims must be submitted to both the HMO and the FI/MAC. We review hospital data to ensure that claims are submitted accurately and timely. Teaching hospitals and hospitals qualifying for DSH are greatly impacted and we have assisted our clients with collecting hundreds of thousands of dollars since this rule went into effect.

Revenue Cycle Services

Our complete understanding of the revenue cycle has translated to millions of dollars in recoveries for our clients ranging from critical access hospitals to large teaching institutions. We have assembled a team of billers, coders, and nurses to ensure we take a multidisciplinary approach to meeting your specific needs.

Billing Services

Cash flow is the life-blood of a hospital's operations. Understaffed billing departments and even fluctuations in geographical population can cause periodic backlogs hindering collection efforts. We have a team of billers ready to provide billing services to meet your temporary or long-term needs. We assist clients with all aspects of billing including claim submission, outstanding accounts receivable reviews, payment posting, and denial management.