Our Services
Our Services
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At The Coding Doctors, we provide end-to-end medical coding, auditing, and revenue cycle solutions designed to improve compliance, reduce denials, and safeguard revenue integrity. Our services are structured to cover every critical aspect of the healthcare revenue cycle.
At The Coding Doctors, we provide end-to-end medical coding, auditing, and revenue cycle solutions designed to improve compliance, reduce denials, and safeguard revenue integrity. Our services are structured to cover every critical aspect of the healthcare revenue cycle.
1. Risk Adjustment / HCC Coding
1. Risk Adjustment / HCC Coding
We specialize in Risk Adjustment (HCC) coding for national payers, including projects for Centene, Aetna, and UHC. Our certified coders ensure accurate capture of chronic conditions, leading to improved RAF scores and better reimbursement outcomes.
Key Capabilities:
Comprehensive HCC coding for Medicare Advantage and ACA plans.
MRA project experience with consistent ≥97% accuracy.
Proactive query process to clarify documentation gaps.
Continuous updates on CMS and payer-specific guidelines.
2. Inpatient & Outpatient Facility Coding
2. Inpatient & Outpatient Facility Coding
Our team provides accurate and compliant coding for both inpatient and outpatient facilities, helping providers and hospitals achieve operational efficiency and improved reimbursement.
Key Capabilities:
Inpatient DRG coding and validation.
Outpatient coding across Surgery, ED, Radiology, and ancillary services.
Specialty coverage including Orthopedics, Cardiology, and Gastroenterology.
Alignment with official coding guidelines and payer-specific edits.
3. Professional / E&M Coding
3. Professional / E&M Coding
We deliver coding support for outpatient professional services and E/M coding across multiple specialties. Our experience with 10+ physician groups ensures consistency and compliance in provider documentation.
Key Capabilities:
Outpatient E/M coding for multi-specialty practices.
Coverage for primary care, pediatrics, and specialty clinics.
Alignment with the latest E/M guidelines (2021+ updates).
Strong focus on compliance and documentation integrity.
4. Revenue Cycle Management
4. Revenue Cycle Management
Beyond coding, we provide RCM support services to streamline billing processes, improve first-pass claim rates, and reduce denials.
Key Capabilities:
Eligibility verification and prior authorization support.
Medical billing and charge capture.
Denials management with root-cause analysis and appeals.
Accounts receivable follow-up and payment posting.
Custom client reporting and performance dashboards.
5. Compliance & Auditing
5. Compliance & Auditing
With a dedicated independent Quality & Compliance wing, we provide robust audit and compliance services that safeguard against revenue leakage and regulatory risk.
Key Capabilities:
Baseline compliance reviews at the start of each engagement.
≥10% audit coverage for tenured coders.
Root-cause analysis and corrective action plans.
Support for CMS audits and payer reviews.
Trend reporting and retraining programs.
6. Workforce Deployment
6. Workforce Deployment
We provide ready-to-deploy certified coders with flexible engagement models, available onsite at client locations or offshore. Our teams are structured for scalability and continuous quality assurance.
Key Capabilities:
Workforce capacity for rapid ramp-up.
Onsite deployment supported by offshore delivery.
Dedicated team leads for supervision and client communication.
Embedded auditors (10% of workforce) for continuous QA.
Structured ramp model: Onboarding → Pilot → Full Production.
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