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Medical Review Audits - Underpayments and/or Overpayments 

Our team is compiled of Certified Professional Coders (CPC). This certification enables us to appropriately process medical review audits. We audit the medical record from the initial patient information, to the E/M visit level, to any ordered procedures or tests. We then apply the appropriate CPT code with the level of care provided. We will also revise the numeric Diagnosis code billed to ensure that it was accurately matched with the medical provider office notes.

We will provide the medical center with the appropiate medical criteria's used by Third Party Carriers in order to maximize payment. The same criteria's are often used by privately owned insurance companies as by government owned insurances. The audit also searches for under coding and missed billing procedures. Our unique approach combines an in-depth understanding of the facility and the combination of the present diagnosis/procedure/billing code combination which enables us to assist the facility to increase its profits.