Coding Audits

  • Payment integrity audits.
  • Correct coding audits based on NCCI principles.
  • E/M level utilization and benchmarking.
  • Medical Necessity Audits.
Case Studies
Risk Score Optimization through CDI
Scope: A major university-based health system wanted a thorough review of their documentation to see if it was supporting the level of care they are providing to the risk adjusted patient population.
Provider Data Management - Process Innovation and Technology Result in Cost Savings
The Challenge: A cost intensive update process required checking data on all provider information update forms, rather than the ones which were actually changed (typically only 40%).