A full suite of end-to-end revenue cycle management services for hospitals with professional billing, coding and patient management services
Get access to certified coders with experience in outpatient, inpatient, & emergency department coding. We have a pool of HCC coding specialists as well.
Learn the basics and a bit beyond, from zero knowledge and skill to decent playing skill
Hierarchical condition category (HCC) coding is a risk-adjustment model originally designed to estimate future health care costs for patients.
Medical billing is a process that involves submitting claims for the healthcare services that you provide to patients.
As an executive – accounts receivable caller, you will be responsible for making calls to insurance companies to follow-up on pending claims.
Claims processing is an intricate workflow involving 20+ checkpoints that every claim must go through before it’s approved.
Medical coding audit helps healthcare providers enhance and implement correct clinical documentation processes. Effective audits have ensured the recovery of millions in improper payments in Medicare and other insurance schemes. In today’s competitive healthcare landscape healthcare organizations must have regular auditing practices in place to promote organizational transparency and employee performance. However, to witness the right outcomes, organizations need to partner with an experienced medical coding audit partner.
Outsource2india has over 24 years of experience in providing in handling the most complex coding file audits with absolute expertise and integrity. We specialize in end-to-end medical audits; from outpatient and inpatient procedures to behavioral and dental health treatments. We designate a qualified team to audit your files, create controls to catch and prevent mistakes and set up correct benchmarks for improvement. Our clients bank heavily on our understanding of codes and experience to make their healthcare processes compliant with regulations and save on expenses and time.
As an established medical coding audit services providing company, we provide a range of coding services to our clients. The most important services among them include –
Auditing Incorrect Use of CPT Codes
We audit CPT codes to determine if it has been improperly used. Issues arise at the time of unbundling, upcoding, improper reporting of time-based codes, using unlisted codes without documenting, failing to check National Correct Coding Initiative (NCCI) edits when reporting multiple codes. We look into each of these aspects during the review.
Auditing Right Place of Service
Many codes are to be used on claims to specify where services were rendered. Each payer has their place of service code. We audit codes to ensure there are no mistakes in the place of service. This ensures you do not get paid less for your services.
Auditing Incorrect Use of Modifiers/ Missing Modifiers
Improper use of modifiers can result in denial of claims. We audit files for missing or misplaced modifiers. Our modifier audits are carried out to tell payers that there were special circumstances regarding the provision of care. Our assessment of the correct use of modifiers is based on rules as well judgment.
Auditing Incorrect Diagnosis
When submitting claims for payment, the diagnosis codes reported with the service tells the payer as to why service was performed. The right codes help support the medical necessity of the procedure. We audit files to ensure the assigned codes correspond with the medical necessity. Likewise, we audit to ensure the diagnosis code for a patient is not changed to match the diagnosis codes listed in the coverage policy.
Auditing Correctness of Operative Reports
We audit operative reports ensuring there are no errors in the coding for post-operative diagnosis. We also make sure that coding for further defined diagnoses or extra diagnoses found in the operative report is complete and correct. Our task entails checking if the codes are the latest and are correct.
Auditing Documentation to Make It Apt For Procedure
We audit files to check if all the documentation leading to the procedure are correct. We check the files for the checkup reasons and related history, physical examination findings, and diagnostic test results, place of service, date and identity of the provider, clinical impression or diagnosis, plan for care etc. Our audit ensures there are no shortcomings in the documentation to cover the procedure.
Audit to Identify Bundling or Cluster Issues
Bundling codes need to be audited and understood well to ensure providers do not get paid less. We audit the single code that is used to replace the other codes to ensure the payment made under the single code covers all the basic costs of the procedure. We review files to ensure compliance with Local Medical Review Policy and National Correct Coding Initiative.
Provide Recommendations Based on Audit Findings
Our coding audit services also includes providing audit recommendation for correcting problems. Our audits take into account the cause of issues. Our recommendation involves documenting in details about the ways to fix the existing flaws and address the actual cause to eliminate recurrence of coding mistakes or failure to comply with laws and regulations.
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 company –
During the process of coding, a lot of unwitting mistakes happen and in most of the times, they get interpreted as false representations. Such mistaken impressions can cause providers to get entangled in legal issues. Medical coding helps to eliminate such a possibility.
Sometimes provider coding varies greatly from national averages. This can be a sign of an inherent and deep-rooted flaw in the system and can lead to huge revenue loss. The medical coding audit helps to measure the consistency of coded medical data. Timely detection of variation helps in improving coding quality and complying with federal guidelines.
Regular medical coding audits help to find problem areas early on in the process. Based on the audit findings providers can take appropriate corrective action. This way healthcare providers can stay safe from violating government rules and payer rules and inviting legal and penal actions.
Sometimes outdated knowledge of coding can lead to undercoding, code overuse or poor unbundling habits. All this results in claims delay or denials or worse. Medical coding audits can help avoid these situations by nipping issues in the bud and help the provider stay compliant at all times.
A common issue with most healthcare providers is lost reimbursement opportunities due to reduced payments. Coding audits help uncover all reimbursement deficiencies and ensure there is no such repetition in future.
As a reputed medical coding audit service provider, our audit services offer the following benefits to our clients –
Lower Costs of Operations
Appeals to medical denials are always a costly and time-consuming process. Our audits assist you to monitor your internal processes across a range of metrics and help you can gain a holistic view of the entire revenue cycle thereby reducing the need to spend money and time on countering denials.
High-quality Audit to Lower Rate of Claim Denials and Rejections
We assist our client’s lower rate of claim denials and rejections by categorizing and analysing them for issues that lead to errors. This helps put a complete check on improper coding and consequently helps in checking fewer payments and denials.
Patient Data Security
Being a top medical coding audit company, we make sure the data is highly secure. We are compliant with the ISO/IEC 27001:2022 standards and ensure the best protection to your data.
Improve Compliance with Regulations And Coding Guidelines
We audit files to ensure issues such as fraud, abuse, upcoding, unbundling etc. that lead to compliance violations are under complete check. We also ensure that issues like lack of documentation or documentation with errors are eliminated to comply with HIPAA rules.
Meets Office of Inspector General Requirement (OIG)
We assist our clients to establish compliance standards by developing a code of conduct consisting of written policies and procedures. The overarching objective is to assist employees to carry out their job responsibilities with perfection.
Educate and Train Physicians And Other Coding Staff
After the audit, we educate the staff on the flaws and ways to improve coding practices with proper checks and benchmarks in place. Our post-evaluation coding education entails teaching staff on modifier usage, CPT-4/ICD-9-CM coding, Mid-level provider coding etc.
Scalable Services
We offer ways to help you scale our solutions on demand. If you deal with bulk medical data coded and ready to be filed, we’ll will alleviate the workload.
Quick Turnaround
We believe agility is everything in medial coding audit performance. We work with medical coding audit tools and technology to accelerate the outcome.
Experienced Medical Coding Auditors
We have highly qualified auditors with rich experience in the medical coding framework. Our team includes professionals who have no less than 8 years of experience as an auditor.
Reliable Customer Support
You may contact our team of qualified medical coding support agents with whom you can keep in touch to get project updates or stay in touch.
Are you looking for accurate and error-free HCC medical coding services that will help you streamline your processes? Are you on the lookout for skilled and experienced HCC medical coding experts who can take care of all your requirements? Then, the best option for you would be to outsource HCC medical coding services to an experienced HCC medical coding service provider.
Outsource2india is one such HCC medical coding service providing company that can cater to all your needs with ease. We have some of the most experienced HCC medical coding experts who can take care of all your requirements with ease. We leverage the latest tools and technologies while delivering the best quality services to global clients.
Corida Technologies has been a pioneer in providing the best quality HCC medical coding services to global clients for over two decades. We understand each client’s unique requirements and provide them with customized services that will suit their business requirements. Some of the key HCC medical billing and coding services we offer include –
Are you worried about the increasing number of pending claims and the accuracy of medical codes? Is the untimely reimbursement a cause of concern for you? An expert understanding of ICD-10 and CPT codes bring dramatic changeover in the way you get paid. It also clarifies disease management, simplifies research approach, and explains how to pursue public health.
Outsource2india is a leading medical coding service provider with almost two decades of healthcare support service experience. Our medical coders are proficient in documenting the patient’s medical state with an appropriate code, thereby leading to timely claim payments for your healthcare facility. Also, our medical coding quality and safety standards are risk-stratified. Outsourcing CPT and ICD-10 coding services to us will help you save time and boost your healthcare organization’s cash flow.
With the ever-changing health care regulations and strict policies put in place via government entities, clinical coding and analysis have become quite challenging. Inaccurate or incomplete submission of codes can result in a large number of claims being denied and underpayments, and cause disruptions and bottlenecks in coding workflows. This can leave you with unnecessary claim-related headaches and billing problems. Incorrect coding practices, out-of-date reporting methods, or even untrained coding personnel can damage the credibility of a clean claim. With our medical coding analysis services, we aim to minimize risk inside the billing process and streamline medical coding analysis strategies for the future.
Most organizations lack proper resources and enough expertise in medical coding analysis. This is why they choose to outsource medical coding analysis services to an experienced medical coding analysis services providing company like Outsource2india. O2I has a huge workforce, modern infrastructure, and international standard medical coding analysis services to provide efficient and quality output to clients.
Your medical coding analysis to Corida Technologies enables you to reduce compliance risks and optimize your revenue. We have a team of experts (radiology medical billing and coding analysis) that will improve your practice’s finances by streamlining submissions of claims and reducing the time and cost burden of administrative tasks. Our all-inclusive medical coding analysis is available as part of our full medical coding services. We ensure the highest degree of data integrity and match experienced coders to your operations.
We offer an entire set of varied medical coding analysis services, including –
Are you looking for ways to communicate the patient’s complexity? Are you on the lookout for skilled and experienced risk adjustment HCC coding experts who can cater to your needs? Then, the best option for you would be to outsource risk adjustment HCC coding services to an experienced and skilled risk adjustment HCC coding service provider.
Corida Technologies is one such risk adjustment HCC coding service providing company that can be your one-stop-shop for all your needs. We have some of the most experienced risk adjustment HCC coding specialists who can take care of all your needs. We leverage the latest HCC risk adjustment tools while delivering top-notch services.
Corida Technologies has been one of the leading providers of risk adjustment HCC coding services to clients around the globe for over two decades. We understand each customer’s specific requirements and provide them with services that are customized to their needs. Some of the key risk adjustment HCC coding services we offer include –
Our team comprises of AAPC certified coders, who receive the highest quality of training.
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