Compliance & Quality
Audit & Compliance
Proactive coding audits, compliance program support, and payer audit defense — find the risk before a payer or the OIG does.
Business outcomes
What this changes for your organization
Audit & Compliance · performance standards
measured continuouslyof audits include corrective action plans
of payer audit findings defended or reduced
annual audit cadence for managed clients
4x
Performance standards we operate to. Actual results vary by specialty, payer mix, and starting position — your free assessment establishes your own baseline.
Our solution
The best time to find a compliance problem is before an auditor does. Our audit team runs scheduled coding and billing audits against OIG work plan priorities, payer audit triggers, and specialty-specific risk areas — delivering findings with financial impact and a corrective action plan.
When a payer audit or records request does arrive — RAC, TPE, MAC, or commercial — we manage the response: records compilation, coding defense, and appeal of any findings, so your team isn't navigating it alone.
What's included
- Scheduled prospective and retrospective coding audits
- E/M distribution and outlier analysis
- OIG work plan risk alignment
- RAC, TPE, and commercial audit response
- Corrective action plans with provider education
- HIPAA-compliant documentation practices review
Common questions
Audit & Compliance, answered
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Ready to fix audit & compliance for good?
Start with a free consultation and billing health check. A senior consultant will look at your numbers and give you a straight answer about what we can improve — and by how much.