Coding Validation Audit

Healthcare Resource Group (HRG) provides compliance audits to identify insufficient documentation and inaccurate, non-compliant coding and DRG assignment.

HRG's auditing team of certified professionals are experts on current coding and compliance standards and can help your Health Information Management (HIM) department achieve coding and compliance accuracy and excellence.  

Coding Validation Audit Services

  • Retrospective audits of coding and related documentation: facility and professional fee (pro fee)
  • Resolution solutions for compliance risk factors
  • Coder education
  • HIM denial management
  • Assessment of CMS compliance
  • Validation of compliant reimbursement
  • Assist with establishing Key Performance Indicators (KPIs)
  • ICD-10 optimization

Coding Validation Audit Comprehensive Solutions

  • Auditing records from specific population of accounts for coders in multiple specialties including: 
    • Emergency Room
    • Inpatient
    • Outpatient surgery
    • Observation
    • Pro fee clinics
  • Analyzing multiple elements of each account including:
    • POA assignment
    • Procedure coding
    • CPT modifiers usage
    • Abstracting accuracy
    • Facility E/M level coding
    • Pro fee E/M level coding
    • Infusion coding
    • Provider documentation

Coding Validation Audit Benefits

  • Regulatory audits risk mitigation 
  • Compliance liability risk mitigation
  • Revenue cycle optimization
  • Reimbursement correction
  • Denial prevention and reduction

The HRG Quality Difference

Our HRG auditing team has 120 years combined experience in facility and pro fee auditing with a wide range of experience and specialties including: PCS coding, orthopedic, neurosurgery, pediatrics, and more!

Schedule Your Coding Validation Audit Today.