COMPLIANCE AUDITING

Compliance Auditing

There are considerable complexities surrounding ICD-10 coding, CDI, and regulatory mandates. We offer AHIMA/AAPC credentialed audit professionals who can validate your current coding and documentation practices, improve, and maintain accuracy. Our auditors help identify coding and documentation trends from both coders and providers. Our compliance professionals provide detailed education to help keep you one step ahead of changing regulatory compliance.

Benefits of Compliance Audits:

• • Establish educational needs by sector
  • Identify Overpayments/Underpayments
  • Ensure Compliance/minimize risk
  • Provide Coder/Provider education upon completion of audit
  • Help Identify trends
  • Concurrent or retrospective audits offered
  • Evaluate remote or on-site coder performance
  • Validate MS-DRG/APC assignments
  • Review HCPCS/CPT, POA, Discharge Disposition and E&M
  • Generate appeal letters
  • Analyze reimbursement impact

Types of Audits:

• • All DRG’s (MS-DRG, APR- DRG/SOI/ROM)
  • Inpatient Coding Audits
  • Outpatient Coding Audits
  • Professional Fee/ Physician- Based Audits

Other Audits provided:

• • Long Term Acute Care
  • Behavioral Health
  • Pain Centers
  • Rehab Audits (UB-04)
  • Anesthesia Audits
  • Risk Adjustment Audit (HCC/ RADV) Coding Audits