Inpatient/Outpatient Coding Assessments
Service is our specialty, that why we provide a thorough review of medical records and compare existing documentation to services billed — ensuring accuracy and compliance with payer coding guideline and overall billing. Additionally we make assessments to see if there are additional services documented that should be billed beyond the primary.
Chart to Bill Audits
We work through Chart to Bill Audits by reviewing outpatient claims from different medical departments to determine if the services billed are properly documented in the medical record. These audits are completed through our use of the coding, billing, and documentation guidelines established by the Centers for Medicare and Medicaid Services (CMS).
Evaluation and Management Audits
In order to conduct this audit, we conduct in-depth review of medical records to compare existing documentation services billed for accuracy and compliance with Medicare coding guidelines. We support the development of Evaluation Management criteria for multiple outpatient departments like Emergency and Pain Management Service.
Revenue Integrity Evaluation
iCode can assist your company by conducting Evaluation and Management audits for multiple physician practices within your health care system. We understand the importance of ensuring existing practices are compliant in their billing and revenue cycle operations. Our core team of experienced coders can effectively provide coding, documentation, and billing compliance audits for physician practices and medical professionals.
Charge Description Master Reviews
Periodic on-site CDM reviews performed by a third party are essential to maintaining and accurate and up-to-date CDM. Our expert coders and coding professional specialize in assisting your facility in achieving CDM compliance, thus helping you to achieve long term goals with an effective Revenue Cycle and the submission of clean claims.
Medical Necessity Solution
We work as a third party to help review cases as a result of false claims during inpatient documentation practices. Incorrect diagnosis and procedure coding leads to overpayments and the false claims, mentioned above — for this we perform a case management operational assessment. We work with hospital case managers to resolve issues and create effective plans around medical record reviews that affect the accuracy of the level of care determinations and medical necessity.