Clarity Coding, Inc.

We cover the world of coding.

Auditing Services

The quality and accuracy of medical record coding for reimbursement purposes is essential to the business of healthcare. Regulatory requirements, business Best Practices, and professional ethics demand strict adherence to current coding guidelines. Healthcare providers have a legal, contractual and fiduciary duty to bill accurately and completely for their services. Regular assessments of coding practices and audits of coded charts are key tools for measuring coding and billing accuracy.

Our Audit program is headed by Linda Holtzman, who developed the Provider Audit departments at two Blue Cross plans. She literally "wrote the book" on how Blue Cross performs provider audits. We are able to provide valuable insight into payor audit methodologies, selection criteria and claims edits. We also follow the medical record to the UB-92 for claim submission to payors to verify accuracy through the billing process. After all, there's little value in coding the medical record correctly if it isn't reflected in the bill.

Clarity Coding offers comprehensive Audit Services for hospitals and physician practices, covering inpatient, outpatient, and office services. We'll show you where you're doing well and where you can improve.

Audit Types

Hospital Inpatient DRG Audits

Hospital Outpatient Surgery CPT Audits

Physician Practice E&M Audits

Audit Steps

1. Sample Selection

2. Case Review

3. Finalization