Medical Coding Audit Services
Chart Reviews, Custom Solutions, Enhanced Revenue.
Financial Impact
Empower Coder Vetting
Quality Assurance
True Subject Matter Experts
Medical Coding Audit Services
- Revenue Cycle Management
- Evaluation & Management Services
- Surgical & Procedural
- Behavioral Health Services
- Ambulatory Surgery Center (ASC)
- HCC & Risk Based Services
- Emergency Department & Critical Care
- FQHC & RHC Services
- And More...
Our Approach to Medical Coding Audits
To ensure accurate coding, the YES Team starts with a thorough review of encounters in alignment with official coding guidelines. We provide review vetting reports and rely on coders' feedback. The YES Team generates a comprehensive report by coder, facility, financial impact, or other data points specified by the client. Trending reports are provided to identify patterns and root causes of recurring issues.
In the post-audit stage, our dedicated in-house coding education team can provide tailored education based on audit insights, one-on-one coder mentoring, provider education, and on-demand training. Our comprehensive Education Catalog addresses knowledge gaps.
Audit Findings for Decision-makers:
- 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 CPT Procedural Code assignments
- Verification of ICD-10-CM, 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
Most Common Specialties Audited
- Orthopedics, Rheumatology, & Physical Therapy
- Dermatology & Plastic Surgery
- Cardiology, Vascular, & Pulmonary
- Urology, Oncology, OB/GYN
- Ophthalmology, ENT, & Neuro
- Internal Medicine, Family Practice, & Urgent Care
- Adult & Pediatric
- General Pediatrics & Pediatric Subspecialties
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
Let us help with your due diligence audit
Navigate healthcare mergers and acquisitions with our Due Diligence Audits eBook. Download it now to receive:
- Due diligence coding audit checklist
- Medical practice valuation tips
- Strategies to ensure a smooth transition post-merger/acquisition