Coding Compliance & Audits

Keeping Physicians Compliant

The healthcare landscape is constantly evolving with new rules and regulations that are fundamentally changing the way physicians work and practice. The world of coding is just one of these frequent changes that occur on a regular basis. From ICD-9 to ICD-10 to RAC Audits to new modifiers, it is a challenge to keep pace with the new rules and coding practices.

MedRCM has a team of certified coders that help physicians in 50+ specialties to not only code correctly but also look for opportunities where physicians may be under-coding. We can provide both proactive and retroactive coding audits to ensure that practices remain compliant with coding guidelines. In the daily life of a practice, it’s easy to repeat broken processes or mistype information due to the fast-pace environment.

CMS recommends that providers seek external reviews to help ensure that practices remain compliant in order to avoid potential fines and hours of time with paperwork. MedRCM’s team has kept many practices compliant, saving them hundreds of thousands of dollars in fines. In addition, we’ve helped prepare organizations with proper self-reporting when experiencing an OIG audit.

What MedRCM Delivers

  • Proactive claim and document reviews identify coding and modifier errors
  • Expert coders help you avoid legal and financial exposure
  • Unbiased reviews prepare you for OIG and RAC audits
  • Comprehensive analysis of your contracts, claims, and payments to find potential underpayments
  • Allows your staff to focus on patients while receiving additional training and education from our experts

Reduce Compliance Risk

  • Achieve coding accuracy at the highest level to help prevent missed revenue opportunities.
  • Meet compliance obligations and receive recommendations to help you achieve desired coding outcomes.
  • Identify under or overbilling of services from comprehensive reviews and charge capture audits.
  • Optimize front-end and back-end billing processes to help streamline operations and improve overall billing integrity.
  • Ensure appropriate billing for documented procedures to help mitigate risk.
  • Uncover trends and identify opportunities for improvement to achieve financial and data-quality goals.