Coding Reviews Services

The Vendor is required to provide reviews of billing, coding and documentation accuracy and compliance with federal regulations and guidelines.
- This project includes quarterly review of claims associated with agency clinic visits from the prior quarter for billing, coding and documentation accuracy.
- Vendor will provide statistical analysis of findings and trends with recommendations.
- Reviews will be of professional fee claims.
- Services are to be provided offsite.
- Specialties that will be included in the records to be audited:
• Family medicine
• Pediatrics
• Internal medicine
• Behavioral health
• Surgery
• Ob/gyn
• Cardiology
• Omm
• Neurology
• Addiction medicine
• Virtual care
• Emergency medicine