STRATEGIC & TECHNOLOGY
Find Revenue Leakage Before It Costs You
A structured, objective evaluation of your billing and coding workflows to uncover discrepancies, identify missed revenue, and reinforce compliance.
Discrepancy review
Audit Findings
E/M Under-coding Risk
Modifier 25 Alignment
Identify Missed Revenue
Uncover under-coding patterns and missed charge captures.
Reinforce Compliance
Highlight risks associated with over-coding or mismatched documentation.
Process Optimization
Translate audit findings into clear operational improvements.
THE CHALLENGE
Hidden Discrepancies Drain Practice Health
Without routine review, systemic coding errors and workflow bottlenecks can silently erode revenue and increase compliance risks over time.
OUR APPROACH
A Structured Review Framework
We evaluate a representative sample of encounters, comparing provider documentation against billed claims and payer reimbursements to map the full lifecycle of a charge.
- Sample encounter selection
- Documentation-to-claim comparison
- Modifier and bundling analysis
- Payer remittance review
- Root-cause identification
- Executive readout
WORKFLOW
Our Seven-Step Audit Process
Scope Definition
Defining the audit goals, specialties, and encounter timeframe.
Data Collection
Gathering clinical notes, submitted claims, and ERAs.
Documentation Review
Validating that notes support the billed complexity.
Coding Analysis
Checking for accurate ICD-10, CPT, and HCPCS assignment.
Reimbursement Check
Verifying payments align with contracted fee schedules.
Pattern Identification
Mapping recurring eight common issue patterns.
Action Plan
Delivering a concrete strategy to address findings.
CAPABILITIES
Supported Workflows
E/M Leveling Check
Reviewing Evaluation and Management code accuracy.
Surgical Coding Review
Analyzing complex operative reports and global periods.
Denial Root-Cause
Investigating why specific procedures face high rejection rates.
Compliance Readiness
Preparing your practice for external payer audits.
OPERATING MODEL
Translating Findings Into Action
An audit is only valuable if it leads to improvement. We focus on delivering actionable insights rather than just pointing out errors.
Clear Executive Summaries
High-level overviews of revenue impact.
Provider Education
Constructive feedback loops for clinical teams.
Workflow Adjustments
Tactical changes to your front-desk or billing processes.
Ongoing Monitoring
Establishing baselines for future continuous review.
SPECIALTY EXAMPLES
Adapted to the practice context
Scope, workflows, and responsibilities are confirmed for each practice. These examples show where this service may be applied.
Multi-Specialty Practices support example
Administrative workflows may include scheduling, communication, insurance coordination, records organization, and back-office follow-up based on the practice’s needs.
View Multi-Specialty Practices servicesSERVICE FAQ
Questions about this service
Ready to Strengthen Your Revenue Cycle?
Talk to our team to explore a framework that fits your practice's workflows.