Medical Coding Audit Services
Precision Audits, Custom Solutions, Enhanced Revenue.
Financial Impact
Empower Coder Vetting
Quality Assurance
True Subject Matter Experts
Medical Coding Audit Services
- Coding Compliance
- Provider Documentation Audits
- Reimbursement Audits
- Focused Audits
- Trending & Data-Financial Goals
- Identify Under And Overbilling
- Coder Mentoring Programs (99% Accuracy)
- Executive Summary Webinar With CEU
- Focused Education Per Audit Findings
Our Approach to Medical Coding Audits
To ensure accurate coding, the YES Team starts with a thorough review of patient encounters in alignment with official coding guidelines. Coders must meticulously review vetting reports and provide feedback. The YES Team generates a comprehensive report (by coder, facility, financial impact, etc.), providing insights and addressing knowledge gaps with tailored education. Finally, trending reports are generated to identify patterns and root causes of recurring issues.
Audit Findings for Decision-makers:
- Compliance Insights
- Root Causes impacting Coding Quality and Claims Reimbursement
- Verification of ICD-10-CM Diagnosis Code assignment, including Principal and Secondary Diagnoses
- Verification of ICD-10-PCS and ICD-10-CPT Procedural Code assignments
- Verification of ICD-10-CM, ICD-10 CPT, Modifier, and Surgeon/Assistant Surgeon code assignments
- Prioritization of Financial Impacts based on Coding Quality
- Medical Coding and Provider Documentation Educational Opportunities
- Verification of coding accuracy for medical necessity
- HCC log and Educational Opportunities
Data Insights By:
- Facility
- Coder
- Provider
- MDC Classification / DRG Grouping / DRG Trending
- HCC
- Focused Requests
What our Clients say about us:
“North Mississippi Health Services has engaged YES HIM to conduct coding audits to verify compliance and accuracy for accurate and compliant coding. They are a wealth of knowledge, always go above and beyond to ensure we have all the necessary education and tools to get the job done! The timeliness and follow through is unbelievably exceptional. Our coders look forward to the feedback and truly trust in the skills of the auditors. We wouldn’t hesitate to say that YES HIM comes highly regarded and recommended!”
System Director, Health Information Management, Tupelo, MS