Medical Coding Audit

The American Health Information Management Association — or AHIMA — reports that medical coding mistakes and inaccuracies are one of the leading causes of billing errors and lost revenue for healthcare organizations. What’s more: Due to the recent changes in ICD-10-CM, as well as the ongoing steps that are required to properly maintain electronic health records, medical coding and documentation auditing is an insightful method of proactively examining where problems lie in an organization’s medical documentation.

Instead of waiting for problems to negatively impact your organization’s cash cycle or an external audit to be ordered due to code-related issues, consider working with HealthCare Resolution Services. We’re fully qualified as a coding compliance auditor to give you an independent third-party view of your entire coding process.

The Importance of a Medical Coding Audit

When an organization chooses us to conduct a medical coding audit, it may have many reasons for doing so, ranging from efficiency to liability issues. Here are some of the top reasons organizations engage medical coding audit agencies:

  • Eliminate fraud: We work to uncover false claims and protect the organization against fraudulent billing activities.
  • Detect coding variations: When an organization’s coding varies greatly from national averages, it can be a sign of improper coding and lost revenue.
  • Identify problems early: To prevent insurance providers and government associations from challenging an organization’s coding practices, an independent audit can find problem areas early on in the process so that the organization can take appropriate corrective action.
  • Remedy undercoding: When undercoding, poor unbundling habits or code overuse exists, it can cause problems down the line. An audit can help remedy these situations by pinpointing where the issues occur so that the organization can prevent them moving forward.
  • Uncover reimbursement deficits: Lost reimbursement opportunities can be costly. Audits help discover where reimbursement deficiencies occur so that these opportunities aren’t lost in the future.

Why Choose HCRS for Your Next Medical Coding Audit?

With over two decades of successfully helping healthcare organizations increase their financial well-being and run more efficiently, it’s no surprise that we’re an industry leader in medical coding auditing trusted by civilian, military and governmental agencies alike.

Illustrating our record of success is the fact that we’re responsible for the coding and auditing of over 3 million medical records annually for the Air Force, Army and Navy. Plus, we consistently maintain a 95 percent or greater level of accuracy. In addition, we assisted the Medicaid Integrity Program — or MIP — with the recovery of $40 million in improper payments.

Our track record for success doesn’t stop there. When you consider that in the past decade, we’ve correctly identified $8 in incorrect payments for every $1 of investment in our medical record audit services, it’s clear that you can greatly improve your organization’s potential to uncover its weaknesses and take corrective action when you work with us.

To learn more about protecting the well-being of your organization, your staff and your patients, contact us today. We handle even the most complex reviews with experience and integrity. Whether you’re a civilian hospital, a VA facility or some other government organization, we’re here to help with medical audits pertaining to everything from inpatient and outpatient procedures to dental and behavioral health treatments.


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