Coding Reviews/ DRG Validation/ Claims Analysis:
IMEDECS provides expert claims analysis; comprehensive coding review and DRG validation services to help maximize your healthcare billing or assess over/under-billing and compliance. IMEDECS reviews clinical, billing, and reimbursement documentation as well as nationally accepted and payor-specific standards and regulations in making determinations. Submitted healthcare claims are compared against medical records and governing regulations to verify that the treatment claimed for reimbursement was actually performed and documented as required.
Our highly qualified and experienced staff provide assistance through strategic cost containment and a comprehensive claims review approach, which utilizes the expertise of physicians, attorneys and Certified Professional Coders (CPCs).
We can accommodate your needs with the following coding services:
- DRG validation/billing (experts have extensive experience in patient acuity & resource utilization)
- CPT validation/outpatient coding
- Appropriate use of modifiers
- Medical record documentation (includes medical necessity review)
- Usual and customary review
- Inpatient/outpatient audits
- Appeal /binding resolution services in any of these areas
- In compliance with NCCI edits and/or other standard coding procedures
IMEDECS’ coding review services are available on a professional, outpatient facility, and inpatient charges and can be conducted on a case-by-case basis or as part of an audit, in conjunction with your compliance program. Our experience and expertise allows IMEDECS to provide a high quality finished product realizing maximum benefits.
To see a sample Coding report, click here.