Accurate clinical documentation and coding are critical to ensure proper reimbursement, compliance, and optimal financial performance. Our Comprehensive Chart Auditing and DRG (Diagnosis-Related Group) Review Services help healthcare providers identify documentation gaps, optimize coding accuracy, and mitigate audit risks.
Our Services Include:
1. Comprehensive Chart Auditing
We perform detailed audits of patient medical records to verify that documentation accurately reflects the care provided and aligns with coding standards.
-
Review of clinical documentation for completeness and accuracy
-
Verification of coding consistency with ICD-10, CPT, and HCPCS standards
-
Identification of missing or insufficient documentation that could impact reimbursement
-
Recommendations for improved documentation practices
2. DRG Review and Validation
Our team evaluates DRG assignments to ensure accurate grouping and optimal reimbursement while maintaining compliance with payer and regulatory guidelines.
-
Analysis of DRG assignments for accuracy and appropriateness
-
Identification of potential DRG downgrades or upcoding risks
-
Recommendations for DRG corrections and appeal opportunities
-
Support in case of payer audits or disputes
3. Risk Mitigation and Compliance
We help protect your organization from compliance risks by ensuring that charts and coding practices meet regulatory and payer standards.
-
Assessment of compliance with Medicare, Medicaid, and commercial payer requirements
-
Identification of potential audit vulnerabilities
-
Implementation of corrective action plans and training
4. Reporting and Actionable Insights
Our detailed audit reports provide actionable insights to improve coding, documentation, and overall revenue integrity.
-
Executive summaries and detailed audit findings
-
Recommendations for process improvements
-
Trend analysis and reporting to support revenue cycle optimization
Why Choose Our Services?
-
Accuracy: Ensures proper documentation and coding to maximize reimbursement
-
Compliance: Reduces risk of audits and penalties
-
Expertise: Experienced auditors with deep knowledge of DRG, ICD-10, and CPT coding
-
Efficiency: Streamlined auditing processes to deliver actionable insights quickly
With our Comprehensive Chart Auditing and DRG Review Services, healthcare organizations can improve documentation quality, ensure coding accuracy, optimize reimbursement, and maintain compliance with confidence.
