Due Diligence Audits – Managed Resources

Mergers & acquisitions are steadily on the rise in the healthcare industry.

In any given year, hundreds of practices are successfully purchased—but often the buyer has limited insight into the compliance standards of these newly acquired practices. Revenue compliance and risk assessment are therefore pressing concerns for any buyer.

How Can CodingAID Help with Compliance?

CodingAID has a highly experienced team of coding compliance experts that can quickly and effectively evaluate coding quality and accuracy rates. Our staff conduct thorough audits based on the clinical documentation and an examination of the assigned codes for CPT, E/M, HCPCS, Modifiers and Diagnoses. At the end of our engagement, our in-depth reporting will help provide a clear picture of the revenue compliance of the practice in question, identify any red flags, and help ensure that the acquisition is a sound investment.

Our Process

1

Project Kickoff

Discuss with the client the project scope, introduce project management team, set communication protocols, clarify deliverables and set audit completion timeline.

2

Data

Receive data from the client via a secure format. This data includes coded patient records, billing claims forms, and coding protocols.

3

Audit

Audit commencement. Team leads will communicate with the client as needed to answer any questions that may impact the audit results.

4

Reporting

Final reports are prepared and sent to the client for review.

5

Audit Results Q&A

Our team is made available to answer any questions or provide clarification on any issues identified to ensure 100% satisfaction with the review.

6

Executive Summary

Executive Summary is completed and delivered. Project is completed.

Our Approach

Our program is designed to strengthen your compliance and coding accuracy through expert coding services, detailed reviews, and in-depth reporting and education. We work within your framework and in line with national guidelines to provide dependable and profitable coding support.

Our performance & reputation are built on:

The dependability, knowledge, and experience of our team
Our exceptional quality and service delivery in coding support, coding audits, and education
Our consistency and timeliness in meeting client goals
Our reliability in communication and service adaptability
Our ability to partner with clients and become a trusted resource

Our Team

Our professional coding and audit experts are highly qualified to report and educate on coding guidelines, documentation best practices and more.

10+ years in experience performing coding audits, identifying compliance risks, documenting trends, providing education, and reviewing complex and highly specialized cases
Certified in CPC, CCS, CCS-P, CDIP, CCDS, RHIA, RHIT, CPC, COC, RN, LVN and similar credentials
Familiar with various EMR systems (Next Gen, Meditech, Cerner, Epic, etc.)
Experience working at trauma level 1 and teaching facilities where complex and highly specialized cases are routine

What People Are Saying About Us

The Managed Resources clinical appeals team have been excellent to us! Not only in having such a positive impact in recovering appropriate reimbursement for denials, but for their personal and timely approach to sharing educational tools with us to help prevent future denials. They really provided us with a high quality of service.

Tri-City Medical Center

I can honestly and without hesitation declare these to be the absolute finest, most thorough, comprehensive and convincing clinical appeal letters I have ever seen in my 25+ year career as a hospital revenue cycle leader.

Vice President Revenue Cycle Services KPC Healthcare Inc.

CodingAID has worked with our physicians to provide valuable and timely coding and documentation education

Baptist Health

Thank You, Thank You!! I found myself in a huge bind. Inpatient and outpatients accounts in backlog. Reaching out to you saved me. Not only did they provide High Quality Experienced coders, they got my backlog under control/caught up in no time.

Kona Community Hospital, Hawaii

We were really pleased with attention to detail that was provided to us in the review of clinical appeals management and charge capture It was clear to see that your team knew what they were doing!

Jackson Health System