Medical Coding Audits
Reliable healthcare medical coding audits are the key to revenue success.
With increasing overhead and declining reimbursements, it’s mission critical to maximize claim dollars via accurate coding and billing processes. Denials, RAC take backs, abuse, fraud, and waste can drain thousands, if not millions of dollars, from healthcare organizations’ already shrinking bottom lines. MRA’s medical coding audit services ensure coding accuracy, reduce risk, and improve revenue integrity.
AHIMA recommends at least one external medical coding audit per year to drive consistent coding results.
And, much more frequent audits are necessary to maximize those results. The lack of consistent audits results in inconsistencies with coders and chart types, identifying only generalized issues, not the specificity needed to truly pinpoint the problem areas. MRA’s coding experts provide customized audits, ensuring integrity of coded data to prevent fraud and abuse, while identifying specific areas of improvement.
- Prevent or recover lost or missed revenue
- Minimize overall compliance risk with MS-DRG, APC, and APR-DRG validation reviews.
- Ensure ICD-10, CPT, and HCPCS coding is validated and in full compliance.
- Confirm physician documentation and medical coding are in full sync with Medicare and Medicaid coding, billing, and documentation requirements.
Pinpoint actionable areas of improvement.
MRA provides a comprehensive final report containing highly targeted accuracy issues and proactive improvement insights as well as assistance implementing auditor recommendations. MRA’s audit approach works with coders directly to educate and improve coder performance with a recommended development plan, including how to identify future issues and opportunities.
Targeted audits including POA, discharge disposition, modifiers, E&M code assignment, and customized reviews are available.
Medical coding audits drive revenue.
- HIM Director, Children’s Hospital