Ensuring Compliance Through Medical Coding Audits

Advantum understands the value of third-party coding, especially in the ever-changing compliance landscape.

For some healthcare companies, coding presents the most significant conundrum they face. That’s where Advantum enters the picture. Our expert coders make sure your company is fully compliant with all CMS rules and regulations while maximizing your payments. The benefits extend over multiple sectors, including reinforced compliance, fine avoidance, fewer denials, streamlined reimbursements and increased payments.

Our comprehensive medical coding audit services include:

Team of expert and highly experienced certified coders with CPMA (Certified Professional Medical Auditor) certification
Proactive claim and document reviews to identify coding and modifier errors
Unbiased reviews to prepare you for OIG and RAC audits
Comprehensive analysis of your contracts, claims and payments to find potential underpayments
Training and education for your staff and physicians

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Coding Audits FAQ

What is Revenue Integrity in Healthcare?

Revenue integrity in healthcare is the practice of ensuring billing and coding processes are accurate, compliant, and aligned with clinical documentation.

It focuses on minimizing errors, reducing the risk of fraud, and protecting revenue by maintaining consistency between the care provided and the claims submitted. Strong revenue integrity programs also enhance transparency and support the long-term financial health of healthcare organizations.

At Advantum Health, our team integrates compliance checks, coding audits, and technology-enabled monitoring to help strengthen revenue integrity throughout the entire revenue cycle. Discover more about revenue integrity in healthcare here.

What is CMS Compliance?

CMS compliance refers to meeting the standards and regulations set by the Centers for Medicare & Medicaid Services (CMS) for healthcare providers.

It covers areas such as billing accuracy, coding standards, documentation, and participation in programs like MACRA or MIPS. Failure to maintain compliance can lead to denied claims, financial penalties, or even exclusion from federal payer programs.

At Advantum Health, we help providers stay current with CMS requirements through proactive audits, continuously updated workflows, and regulatory expertise designed to help minimize compliance risks.

See how MIPS and MACRA can benefit both patients and profitability.

Maximize Your Revenue Potential

Our AI-powered, outsourced RCM delivers the speed, accuracy, and cash flow your current process might be missing. Submit the form for a free workflow analysis and see how we stack up against your vendor or in-house billing.

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502-861-5629
Email us at
info@advantumhealth.com