Coding Audit Service



Coding Audit Services after Charge Entry: Ensuring Accuracy and Compliance


At MedReck BPM, we recognize the vital role that precision and adherence to regulations play in medical billing. Our Coding Audit Services after Charge Entry are tailored to guarantee that each claim submitted is accurately coded, thereby minimizing the likelihood of denials, rejections, and compliance challenges. Through our post-charge entry coding audits, we assist healthcare providers in preserving their financial stability, preventing expensive mistakes, and ensuring compliance with the constantly evolving billing regulations.

What Is a Coding Audit After Charge Entry?


A coding audit following charge entry involves a thorough examination of the medical coding applied to generate claims for services provided to patients. This procedure verifies that the appropriate Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes have been accurately assigned to every procedure, diagnosis, and treatment recorded in the patient's medical history.

Charge entry focuses on recording essential details about the patient, provider, and services rendered. In contrast, a coding audit introduces an additional level of quality assurance by evaluating the precision of the applied codes. This process is crucial for guaranteeing that claims are billed correctly and adhere to payer regulations, which ultimately results in quicker payments and a reduction in claim denials.

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Why Is a Coding Audit After Charge Entry Important?

Accurate coding plays a vital role in the effectiveness of your revenue cycle management. In the absence of proper coding, even the most precise charge entries cannot ensure that claims are processed accurately. This underscores the importance of conducting a coding audit.

Improves Claim Accuracy

Medical coding errors rank among the primary reasons for claim denials. Conducting a coding audit is essential to verify that the appropriate codes are utilized and that they accurately correspond to the services recorded in the patient's medical history. By detecting and rectifying coding mistakes prior to claim submission, we can significantly minimize the likelihood of denials and payment delays.

Guarantees Adherence to Coding Standards

Coding standards and regulations are subject to frequent updates. It is essential to comply with HIPAA, Centers for Medicare and Medicaid Services (CMS) guidelines, and specific payer requirements to mitigate the risk of penalties and legal issues. Our coding audit verifies that your claims align with the most current standards and regulations, safeguarding your practice against audits and potential penalties.

Enhances Revenue Potential

Precise coding is crucial for obtaining the highest possible reimbursement for the services rendered. Insufficient coding may result in missed revenue opportunities, whereas excessive coding can lead to claim rejections and possible audits. Our auditing procedure guarantees that all services are billed correctly, thereby maximizing your practice's revenue.

Minimizes the Likelihood of Audits and Penalties

Inaccurate or inconsistent coding may lead to payer audits, resulting in significant time and expense. By performing comprehensive coding audits following charge entry, we assist your practice in ensuring compliance and mitigating the financial and administrative challenges associated with external audits and penalties.

Our Comprehensive Coding Audit Process

At MedReck BPM, we offer a comprehensive and methodical coding audit process aimed at identifying errors, rectifying inaccuracies, and ensuring compliance throughout the medical billing cycle. Our certified medical coders conduct a thorough examination of your charge entries and related documentation to confirm the accuracy of the coding.

Evaluation of Medical Records

  • A comprehensive coding audit begins with an in-depth evaluation of medical records. We examine patient files, physician notes, treatment information, and diagnostic reports to confirm that the services provided are correctly represented by the assigned codes.
    - Detailed assessment of patient charts and medical documentation
    - Confirmation of the completeness and precision of records
    - Consistency of services provided with the relevant CPT, ICD-10, and HCPCS codes

Validation of CPT and ICD-10 Codes

  • We conduct a thorough validation of the procedure codes (CPT) and diagnosis codes (ICD-10) recorded during the charge entry process to ensure alignment with the medical documentation. This process guarantees that each service rendered is assigned the correct and most precise code, thereby minimizing the likelihood of claim denials.
    - Comparing CPT codes with the medical procedures conducted
    - Confirming ICD-10 codes in accordance with documented diagnoses
    - Ensuring the correct application of modifiers, when necessary

Review of Payer-Specific Coding Guidelines

  • Different insurance payers often establish their own coding and billing regulations. Our team is dedicated to ensuring that the coding practices conform to the distinct requirements of each payer, thereby reducing the likelihood of claim denials or the need for rework.
    - Compliance with payer-specific coding and billing regulations
    - Examination of National Correct Coding Initiative (NCCI) edits
    - Assurance of adherence to guidelines set by Medicare, Medicaid, and commercial payers

Detection of Under-Coding and Over-Coding

  • Our auditors assess occurrences of under-coding and over-coding, as these can adversely affect your revenue and lead to payer audits. We verify that all services rendered are billed accurately, maximizing revenue while ensuring compliance.
    - Recognizing unbilled charges or services billed at lower rates
    - Highlighting cases of over-coding that may prompt payer audits
    - Confirming the correct application of evaluation and management (E/M) codes

Thorough Error Reporting and Suggestions

  • Upon completion of the coding audit, we deliver an in-depth report that highlights any errors, discrepancies, or opportunities for enhancement. Our team also provides practical recommendations aimed at enhancing your practice’s coding precision and compliance in the future.
    - Comprehensive audit reports featuring error assessments
    - Suggestions for remedial actions
    - Continuous support to enhance future coding methodologies

Benefits of Partnering with MedReck BPM for Coding Audits

  • Professional Coding Proficiency

    Our team of certified medical coders (CPCs) possesses a wealth of experience in multiple medical specialties and payer regulations. We guarantee that all coding is precise, current, and adheres to the latest industry standards.
    - Certified Professional Coders (CPC) skilled in diverse specialties
    - Continuous education to remain informed about updates in coding regulations
    - Comprehensive understanding of CMS and commercial payer criteria

  • Decrease in Denials and Rejections

    Our coding audit service effectively minimizes the likelihood of claim denials and rejections by identifying errors at an early stage. This leads to quicker payment processing and reduces the time required for claim revisions.
    - Early identification and rectification of errors
    - Enhanced speed and accuracy in claim submissions
    - Increased rate of first-pass approvals

  • Improved Revenue and Cash Flow

    By implementing precise coding practices, your practice can secure complete and prompt reimbursements for all services provided. This not only boosts cash flow but also strengthens the financial stability of your practice.
    - Optimization of reimbursement opportunities
    - Decrease in revenue loss caused by coding mistakes
    - Enhanced cash flow through expedited claim approvals

  • Compliance and Risk Management

    Our auditing services are designed to guarantee that your coding practices adhere to the most current healthcare regulations, safeguarding your practice against legal liabilities, payer audits, and financial repercussions.
    - Complete adherence to HIPAA and payer guidelines
    - Reduction of audit-related risks and penalties
    - Anticipatory detection of possible compliance challenges

  • Customized Solutions for Your Healthcare Practice

    Recognizing that every healthcare practice has distinct requirements, we adapt our coding audit services accordingly. Whether you operate a small clinic or a large hospital, we modify our audit procedures to fit your unique workflows, specialties, and payer arrangements.
    - Tailored coding audits for diverse specialties
    - Services designed for small practices, multi-specialty groups, and hospitals
    - Flexible solutions to support expanding practices

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The Coding Audit Process: How It Works

Here’s a step-by-step overview of our coding audit process after charge entry:

  • Charge Entry Assessment

    Our team initiates the process by assessing the charge entries to confirm that all pertinent information has been accurately recorded, encompassing patient demographics, procedure codes, and provider information.

  • Verification of Medical Documentation

    We compare the charge entries against the medical documentation to confirm that the appropriate CPT and ICD-10 codes have been accurately assigned in accordance with the services provided.

  • Coding Validation

    Our qualified coding specialists assess the precision of the CPT, ICD-10, and HCPCS codes applied, confirming their adherence to the most current coding standards and payer requirements.

  • Identification and Rectification of Errors

    All coding mistakes or discrepancies are identified and rectified to guarantee that claims are prepared for submission, minimizing the likelihood of rejection or denial.

  • In-Depth Reporting

    We deliver a thorough report that identifies coding errors and offers suggestions for improvement, enabling your practice to improve coding accuracy and ensure compliance in the future.

Are you prepared to enhance your coding precision and adherence?


Precise coding is essential for enhancing revenue and preventing expensive errors. With MedReck BPM’s Coding Audit after Charge Entry Services, you can be confident that your claims are submitted with optimal accuracy and adherence to regulations. Reach out to us today to discover how we can assist in refining your coding practices and boosting your revenue cycle. We offer 24/7 medical billing support via email or visit our website www.medreckbpm.com