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  • Phone: 1-888-406-4711

Overview of Audit Cycle

  • Overview of Audit Cycle100% of a client’s DRG claims are transmitted and screened through our proprietary “rules engine”, identifying an average 30% with the greatest potential for audit results.
  • For those selected claims, Medical Records are then obtained from the hospitals and each one is thoroughly analyzed by our professional coding and auditing experts.
  • When errors are identified, providers’ coding departments receive our detailed recommended changes and rationale based on official coding guidelines and resources.
  • Providers return a signed agreement to our recommended changes enabling us to forward the agreement and the revised pricing detail to our clients to process the credit or refund request.
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