Medical Coding & Compliance Audits
Improve coding accuracy. Reduce risk. Protect revenue.
Gain independent insight into coding accuracy, documentation, compliance, and financial impact with expert facility and professional fee coding audits.
> See how a coding audit improved coding accuracy across 14,674 cases.
Audit solutions to strengthen performance
Professional Fee Audits
- E/M Coding
- CPT & HCPCS
- ICD-10-CM
- Modifiers & Units
- Medical Necessity
- Documentation Review
- And More
Facility Coding Audits
- Inpatient Coding
- Outpatient Coding
- DRG Validation
- APC Validation
- Emergency Department
- Ambulatory Surgery
- And More
Compliance Audits
- Coding Compliance
- Regulatory Requirements
- High-Risk Areas
- Overcoding & Undercoding
- Documentation Integrity
- Risk Identification
- And More
Specialty Coding Audits
- Specialty-Specific Reviews
- Complex Procedures
- Surgical Coding
- High-Risk Specialties
- Documentation Requirements
- Payer Guidelines
- And More
Targeted Audits
- Identified Risk Areas
- Coder Performance
- Provider Performance
- Denial Trends
- Documentation Concerns
- Focused Validation
- And More
Ongoing Audit Programs
- End-to-End Coding
- Dedicated Coding Teams
- Workflow Integration
- Production Management
- Quality Assurance
- Performance Reporting
- And More
Turn coding insights into measurable results
Uncover Hidden Risk
Identify coding errors, documentation gaps, compliance concerns, and recurring trends before they create greater financial or regulatory exposure.
Protect Revenue Integrity
Evaluate undercoding, overcoding, medical necessity, and documentation alignment to uncover opportunities for more accurate reimbursement and stronger financial performance.
Turn Findings Into Action
Move beyond accuracy scores with actionable reporting, root cause insights, targeted recommendations, and education designed to drive lasting improvement.
Trusted by the best
Strategic Approach
From audit findings to lasting improvements
1. Align Priorities
Collaborate with your team to define objectives, audit scope, specialties, risk areas, sampling methodology, and measures of success.
2. Conduct Reviews
Experienced auditors evaluate coding and supporting documentation against applicable coding, regulatory, and payer requirements.
3. Validate Opportunities
Validate findings, identify meaningful trends, and evaluate financial, compliance, and operational opportunities requiring attention.
4. Shape Strategy
Translate findings into executive-level insights, prioritized recommendations, and a practical roadmap for improvement.
5. Advance Performance
Work alongside your team to implement education, corrective actions, workflow improvements, and ongoing performance monitoring.
Trusted since 1994.
Experts that understand your HIM goals
Specialized expertise across revenue cycle disciplines.
HIM Experience
- 25+ years average coding leadership experience
- Credentials include: RHIA, RHIT, CCS, CCS-P, CPC, CIC, COC, CPMA, CDIP, CDIS, CRC and other nationally recognized HIM and coding certifications.
- Facility & Professional coding expertise (former Level 1 Trauma specialists & facility educators)
Clinical Experience
- 30+ years average clinical leadership experience
- Credentials & licenses include: RN, JD, LNCC, CCM, CDIP, CDIS, RHIA, RHIT, CRCR, MHA, MBA, PMP, IMG, and other advanced healthcare credentials.
- Dual-perspective leaders (former payer & provider experience)
Proven healthcare experience that drives better outcomes.
For more than 30 years, Managed Resources has helped healthcare organizations navigate complex revenue cycle, compliance, and operational challenges. Our experience spans organizations of every size and complexity, giving our teams the perspective to understand what works, and how to adapt it to your environment.
- 30+ years serving U.S. healthcare organizations
- 25+ years average leadership experience
- Long-standing healthcare client partnerships
- Enterprise & department-level engagement experience
- Complex revenue cycle transformation experience
- Provider & payer-side perspectives
- Multi-specialty, multi-setting experience
Commitment that delivers. Expertise that adapts.
We don’t force clients into a standard model. We align the right clinical, coding, operational, and payer expertise to your needs, integrating with your organization to expand capacity, solve complex challenges, and deliver measurable results.
- Solutions tailored to your organization’s unique priorities
- Active and accessible subject matter experts and executive leadership
- Collaborative, team-based delivery across key stakeholders
- Transparent communication, reporting & performance visibility
- Flexible, scalable support as your needs evolve
- 100% U.S. based teams with specialized expertise
- Long-term strategic partnership focused on continuous improvement
Our commitment extends beyond completing the work. We stay accountable to outcomes, proactively address challenges, and measure our success by the meaningful, sustainable results we help clients achieve.
Experience across the continuum of care.
Managed Resources understands that revenue cycle challenges look different across healthcare organizations. We bring relevant expertise, scalable resources, and tailored solutions to support each organization’s unique needs.
- Large Multi-Hospital Health Systems
- Academic Medical Centers (AMCs)
- Integrated Delivery Networks
- Community Hospitals
- Critical Access Hospitals
- Specialty Hospitals
- Physician Groups & Practices
- Federally Qualified Health Centers (FQHCs)
- Government Healthcare Organizations
EHR Fluency
Auditors Avg. 10+ years experience
Audit expertise across complex coding areas
Professional Coding
- E/M Services
- Modifiers
- Incident-To
- Split/Shared Services
- Teaching Physician
- Medical Necessity
- And More
Facility Coding
- Inpatient
- Outpatient Surgery
- Emergency Department
- Ambulatory Surgery
- Outpatient Clinics
- Observation
- And More
Coding & Documentation
- ICD-10-CM/PCS
- CPT/HCPCS
- DRG/APC
- Documentation Support
- Cloned Documentation
- Diagnosis Accuracy
- And More
High-Risk Areas
- Overcoding
- Undercoding
- Unbundling
- Modifier Usage
- Medical Necessity
- Regulatory Compliance
- And More
Specialty Services
- Oncology
- Radiology
- Infusion
- Therapy
- Lab/Pathology
- Surgical Specialties
- And More
Providers & Coders
- Provider Accuracy
- Coder Accuracy
- Recurring Errors
- Performance Trends
- Knowledge Gaps
- Education Opportunities
- And More
FAQs
What is a medical coding audit?
A medical coding audit independently evaluates coding accuracy, supporting documentation, and compliance with applicable coding, payer, and regulatory requirements.
When should a healthcare organization conduct a coding audit?
Common triggers include compliance concerns, declining accuracy, denial trends, staffing or vendor changes, mergers, system transitions, revenue leakage, or the need for ongoing compliance monitoring.
Does Managed Resources provide education after an audit?
Yes. Audit findings can be translated into targeted coder and provider education focused on identified errors, documentation gaps, compliance risks, and recurring trends.
Does Managed Resources audit both facility and professional fee coding?
Yes. Managed Resources performs facility and professional fee coding audits across inpatient, outpatient, physician, surgical, ancillary, and specialty environments.
Can coding audits identify missed revenue?
Yes. Audits can identify undercoding and other coding or documentation issues that may result in missed reimbursement, while also identifying overcoding and compliance exposure.
Can Managed Resources customize a coding audit?
Yes. Audit scope, sample methodology, specialties, providers, risk areas, reporting, and follow-up education can be tailored to organizational priorities.
What deliverables are included with a medical coding audit?
Deliverables can include executive summaries, detailed coder and provider audit results, scorecards, accuracy and financial impact reporting, recommendations, and a customizable real-time audit tracker. Reporting is tailored to stakeholder needs and can provide visibility into audit progress, findings, education outcomes, and follow-up actions.
What areas can a medical coding audit focus on?
Audits can be customized around specific coding, documentation, compliance, or financial priorities, including ICD-10-CM/PCS, CPT/HCPCS, E/M, DRG, modifiers, medical necessity, missed charges, documentation quality, and other identified risk areas.
30+ years of Excellence
Testimonials from client partnerships
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Know your risk. Unlock your opportunity.
Gain greater visibility into coding performance while identifying opportunities to reduce risk, improve accuracy, and protect revenue.
