Coding review
Coding and modifier review by appropriately qualified reviewers, with questions sent back to your clinicians rather than guessed.
What's included.
- Code and modifier checks against documentation
- Payer-specific edit review
- Clinical questions routed to your providers
Your billing system stays your system of record. Work involving patient health information starts only after a business associate agreement is signed. Your clinicians own clinical documentation and coding decisions, and payers make every payment decision.
Related services.
- 01
Full revenue cycle management
Day-to-day billing operations in your own billing system: claims, rejections, denials, posting and follow-up, with a monthly report.
- 02
Claims preparation and submission
Claims built from your completed charges, checked against payer edits and sent through your clearinghouse, with acceptance tracked separately from payment.
- 03
Denial management and appeals
Each denial sorted by cause and worked to the right fix: corrected claim, reconsideration or appeal, inside the payer's deadlines.
- 04
Payment posting and reconciliation
Remittances posted to the right claims, with deposits reconciled and underpayments and credit balances flagged.
- 05
Accounts receivable follow-up and cleanup
Working aging balances by payer and age, or a one-time cleanup of old accounts with an agreed inventory and cut-off date.
- 06
Eligibility and authorization tracking
Coverage checks and prior authorization tracking before visits, so fewer claims are denied after the fact.
- 08
Billing setup and payer onboarding
Getting the billing side ready: payer and clearinghouse enrollment, electronic remittance and funds transfer, and the ready-to-bill check for each new provider.
- 09
Billing audits and reporting
A review of how your revenue cycle performs, with defined metrics such as denial rate, days in AR and net collection rate.
Tell us what you're working on.
Share a few details and we'll follow up to talk through scope, timing and next steps. There's no obligation.