Coding and Billing Consulting

Our coding advisors also bring to the table a deep bench of expertise in coding and billing best practices and procedures and can provide assistance related to:

• Performing coding compliance reviews for facility and professional services, as well as specialty providers
• Assisting legal counsel with documentation, coding and billing reviews and engagements under attorney-client privilege
• Providing coding compliance education for physicians, non-physician practitioners and therapists
• Serving as co-sourced resources to conduct coding compliance auditing/monitoring for compliance and/or internal audit departments
• Providing documentation analysis of physician and non-physician practitioner coding and billing of evaluation and management and procedural services to identify risks and revenue opportunities, including high-risk areas such as:
  • ‘Incident-To’
  • Scribe documentation
  • Copy/paste overutilization
  • Split/shared visits
  • Physicians at teaching hospitals (PATH)
  • Critical care services
  • Inpatient rehabilitation facility therapy
  • Analyzing provider evaluation and management bell curves to identify risks and revenue opportunities
• Providing a risk-based approach to monitoring procedural and diagnosis code assignment and modifier application for physician practices and hospital outpatient services including:
  • Emergency room charge capture
  • HBO therapy
  • Facility evaluation and management
  • Radiology
  • Laboratory
  • Chemotherapy/oncology
  • Infusion services
  • Telemedicine compliance and education
  • Optometry
  • Covid-19 ICD-10 reporting
  • Behavioral health

• Reviewing documentation for accurate hierarchical condition category capture, gap analysis and reporting