Medical Coding and
Audit Services
Empower your revenue cycle with 98%+ coding precision, eliminate costly compliance liabilities, and unlock legitimate reimbursements. From specialized ICD-10 & CPT to HCC risk adjustment and rigorous pre-bill chart audits.
Full-Spectrum Medical Coding & Auditing Solutions
Whether you need complete end-to-end coding support, targeted backlog relief, or continuous compliance audits, our certified team integrates seamlessly into your clinical workflows.
Diagnostic & Inpatient Coding
Precise assignment of diagnosis and procedure codes with maximum specificity, preventing unspecified code rejections and capturing full patient acuity.
Exact clinical specificity mapping Comorbidity (CC/MCC) capture Inpatient MS-DRG & APR-DRG assignment Annual code set update calibration
Procedural & Outpatient Coding
Flawless procedural coding compliant with AMA guidelines, ensuring appropriate modifier applications (-25, -59, -X{EPSU}) and zero unbundling issues.
Evaluation & Management (E/M) leveling Complex surgical procedure coding NCCI edit & MUE rule validation DME and injectable drug HCPCS codes
HCC & RAF Score Optimization
Dedicated risk adjustment coders for Medicare Advantage, ACOs, and commercial value-based arrangements, ensuring documentation accurately reflects illness severity.
Prospective & retrospective chart review MEAT criteria documentation validation Chronic condition gap closure RADV audit readiness & defense
Pre-Bill & Post-Bill Auditing
Independent reviews by Certified Professional Medical Auditors (CPMA) to identify under-coding (lost revenue) and over-coding (audit compliance risk).
Pre-bill high-dollar & specialty sampling Post-payment retrospective audits Under-coding recovery identification OIG compliance risk mitigation
Clinical Documentation Improvement
Bridge the gap between clinical intent and compliant coding. We provide non-leading physician queries and specialty documentation guidance.
Real-time physician query support Documentation deficiency trend analysis Specialty-specific provider tip sheets CPOE and note template optimization
Coding Denial Overhaul & Appeals
Systematic remediation of coding-driven claim rejections (CO-4, CO-16, medical necessity denials) combined with feedback loops to eliminate repeat issues.
Root-cause denial classification Appeals with clinical literature support Custom clearinghouse claim scrub rules Weekly coding error scorecard reviews
How We Deliver 98%+ Accuracy Every Day
A rigorous 5-stage quality assurance lifecycle designed to catch discrepancies before claims ever leave your facility.
Dual-Tier Quality Guarantee
Every chart is subject to random audit sampling and continuous specialty scorecard reviews.
Secure Access & Encounter Ingestion
We establish direct, encrypted VPN access into your existing EHR (Epic, Cerner, Athenahealth, eCW, NextGen). Zero local data saving and zero workflow disruption.
Primary Specialty-Specific Coding
Encounter records are assigned to credentialed coders (CPC, COC, CIC, CRC) dedicated to your exact medical specialty, ensuring nuanced procedural understanding.
Algorithmic Scrubber & Rule Engine
Every encounter is evaluated against our proprietary coding scrubber, verifying NCCI edits, medically unlikely edits (MUE), modifier compatibility, and LCD/NCD coverage policies.
Quality Auditor Secondary Review
Certified Professional Medical Auditors (CPMA) perform random pre-bill audits and focused checks on complex or high-dollar encounters to ensure accuracy exceeds 98%.
Clean Claim Release & Weekly Feedback
Validated codes are committed directly into your billing queue for immediate claim generation. We hold regular review calls highlighting documentation recommendations.
Specialized Medical Coding Across 35+ Disciplines
Coding guidelines vary drastically between specialties. Our coders are sub-specialized to ensure unmatched precision in your domain.
We Work Directly in Your Native EHR & Billing Systems
No data migrations. No costly software installations. Our team seamlessly logs into your existing setup via secure VPN or encrypted virtual desktop.
Don't see your platform? We support all major industry PM/EHR software.
Why Leading Healthcare Providers Partner With Us
Delivering measurable improvements in revenue capture, cash velocity, and compliance protection.
100% AAPC & AHIMA Certified
Every coder holds active credentials (CPC, COC, CIC, CRC) and undergoes regular continuing education on annual coding updates.
Eliminate DNFB Backlogs
Guaranteed 24 to 48-hour chart turnaround prevents Discharged Not Final Billed bottlenecks and accelerates your claim submission velocity.
Drastic Denial Reduction
Upfront scrubber rules, modifier precision, and medical necessity validation slash coding-related denials by over 40% on average.
Bulletproof Compliance Defense
Comprehensive audit trails, OIG compliance alignment, and two-tier QA protect your practice against commercial payer clawbacks and RAC audits.
Flexible Engagement Models
Scale up or down on demand. Choose dedicated FTEs, per-chart billing, temporary backlog relief, or quarterly compliance audits.
Transparent KPI Reporting
Weekly executive scorecards reviewing coder productivity, accuracy rates, common error trends, and provider documentation feedback.
Frequently Asked Questions
Everything you need to know about our medical coding and chart audit services.
Ready to Elevate Your Coding Accuracy and Reimbursements?
Request a complimentary 25-chart sample audit. Discover missed revenue opportunities, pinpoint compliance risks, and see how our certified coders will transform your revenue cycle.