Coding and Medical Reviews
Protect against financial losses.
We assess medical records to protect the quality and integrity of healthcare services. Our honesty, credibility, and transparently accurate review processes yield results that surpass expectations.
Decades of experience working with payers such as
Medicare, Medicaid, and commercial plans of various sizes.
Streamline Processes. Optimize Resources. Reduce Operational Inefficiencies.
Our methodology:
HITRUST requirements,
URAC and ISO standards.
Identify. Detect. Prevent.
– Improper Payments
– Overbilling
– Phantom Providers
– Durable Medical Equipment (DME) Scams
– Unlawful Practices.
Prevent the loss of billions of dollars due to FWA in healthcare each year.
Whether you’re a state Medicaid agency, fraud control unit, or commercial managed care organization, our flexible support options cater to your specific needs, instilling confidence in the integrity of your medical programs.
Our expertise, high-quality, and competitive costs set us apart.
We conduct specialty-specific compliance and FWA reviews, leveraging experience across diverse clinical areas (inpatient, outpatient, home health, hospice, skilled nursing, durable medical equipment, behavioral health, and care management).
– Medical necessity of services and/or place of service.
– Procedural and service coding with provision of prevailing charges.
– Quality of care reviews.
– Administrative/legal/benefit/rescission reviews.
Optimize your coding and medical review processes.
Contact us to discuss how our expert team can support your needs.