Clinical & Coding Integrity
The bridge between outstanding clinical care and accurate financial reimbursement is critical. If your documentation doesn’t tell the full story, you risk non-compliance and significant revenue leakage.
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Clinical Documentation Integrity (CDI):
Concurrent and retrospective reviews to improve documentation quality, supporting coding accuracy and compliance
Clinical Prior Authorization
Managing authorizations that require clinical expertise.
Clinical Denials & Appeals
Expert review and appeal of clinically-based denials.
Medical Coding (Facility & Professional Fee)
Certified coders across all specialties to ensure accurate and timely coding.
Risk Adjustment Coding
Maximizing the accuracy of your risk-adjustment factor (RAF) scores for proper reimbursement.
Medical Code Auditing
Proactive audits to identify compliance risks and revenue opportunities.
Clinical & Coding Integrity: Bridge Care and Compliance
Our Clinical & Coding Integrity services ensure this bridge is solid. We deploy a team of certified experts—supported by intelligent technology—to review, refine, and manage your clinical documentation and coding processes. We ensure your records are accurate, fully compliant with all payer and government regulations, and precisely reflect the high value of the care you provide.
We see coding and documentation as more than just a back-office function; it is a critical intersection of clinical quality and financial health. In an environment of shrinking margins and increasing regulatory scrutiny, “good enough” documentation is no longer an option. Our program is built on a foundation of continuous improvement, where our CDI specialists and coding experts act as true partners to your clinical team.
Managing Your Business Doesn’t Have to Be Hard.