Medical Auditing Services | Healthicity

 

Medical Auditing Services

Expert auditors, always at your service. 

Incorrect Coding is Fraught with Risk.

Whether you want to optimize revenue, mitigate risk, or save time and money, our expert auditors can help. Armed with our proprietary auditing tools and decades of experience, our team can help your organization to easily achieve goals. 

Pre-Audit Review

Scoring that Meets Your Needs

We use a scoring methodology that places equal weight on over-coded or under-coded Evaluation and Management services.

Customized for Your Organization

A comprehensive assessment of documentation, coding and billing, we identify your particular issues.

Best Auditors in the Business

We boast a national network of the most highly trained auditors in the industry with expertise in every medical specialty.

Documentation and Coding Audit

Identify existing coding and documentation issues that may affect your organization’s revenue or put your organization at risk for compliance violations. Healthicity can provide the gold-standard in a comprehensive assessment of documentation, coding and billing.

Special Investigations

Validate the accuracy of audit findings for repayment requests. By objectively applying CMS & CPT coding principles and guidelines, we reveal errors in the original review and reduce your repayment amounts. Additionally, our experts will identify areas where a physician’s work is not being accurately reflected in the documentation. Then, through education and documentation tips, your providers can better translate their thought processes into more accurate coding and claims submissions.

Risk Adjustment Audits

Verify compliance and validate documentation and coding to avoid inaccurate risk adjustment or underpayments with an expert HCC audit. We utilize a structured methodology designed to validate the accuracy of diagnosis coding related to HCC categories and determine whether or not records meet CMS’s compliance requirements.

“One of the most productive training sessions I have participated in. The entire group was engaged. I would definitely have Healthicity back again.”

Mathew Spencer, Director of Compliance, UMC System Compliance

Outpatient CDI and ICD-10 Clinical Documentation

Capitalize on overlooked opportunities for improvement, around multiple service lines within your healthcare system or facility by implementing best practice policies and procedures. Healthicity can provide expert outpatient CDI assessment, program development, training and ICD-10 clinical documentation audits.

Underpayment Recovery

Detect payment variances, flag underpaid and incorrectly closed claims and identify inappropriate denials and rejections. At no upfront cost to clients, Healthicity provides an underpayment recovery service that helps hospitals and health systems quickly recover your dollars, enhance your revenues and keep your financials healthy.

Audit Results

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Report & Errors

Your detailed report for each provider includes overall error rates and details on whether or not the provider documented, coded, and billed accurately for each record.

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Audit Details

Through a comprehensive assessment we identify existing coding and documentation issues that may affect your organization’s revenue or cause compliance risks.

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Best Practices

Comprehensive suggestions on how you can improve your documentation. Our recommendations are based on the audit findings.

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Audit Training

Together, we’ll help you evaluate training recommendations and identify the most cost-effective methods available to you.

Auditing Experts

Stephani Scott

Executive Oversight

Stephani has over 20 years experience in the healthcare working closely with physicians and staff in a variety of settings including Hospital, Long-term care, large multi-specialty physician practices.

Charla Prillaman

Regional VP

Charla has more than 25 years experience providing coding, compliance and billing services to physician practices. Charla’s role is to provide post-audit support such as thought leadership, education, and legal support.

Marina Gregory

Audit Director

Marina has over 20 years experience in professional coding, compliance, and billing services. She has been responsible for auditing and providing education to providers, ensuring compliance.

Lara Smith

Regional Director

Lara Smith is an expert in medical documentation and billing education. Lara has expertise in training providers about complex Medicare topics, such as Teaching Physician, Incident-to, and Split/Shared billing.

Elizabeth Wright

Senior Auditor

Elizabeth has worked in medical billing, coding, and auditing for 13 years. Elizabeth is our Senior Auditor for multiple specialties, auditing and educating on documentation compliance.

Schedule a Free Consultation.
Our auditing experts will contact you to discuss your needs.

Product Brochure

Audit Services Brochure

We don’t believe in a one-size-fits-all approach. Before we begin, we’ll talk with you to understand your unique standards that should be applied to your audit.

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