Medical Record Audit Services

Medicare reimbursement rates and bonuses are the driving factors for any Medicare Advantage Plan. Retrieving medical records for the right members, identifying missed diagnoses, and accurately capturing those additional HCCs in RAPS filings typically results in significant incremental revenue for a Medicare Advantage Plan.

Our HCC coding service helps extract all possible HCC codes to support Medicare Advantage plans in completing accurate risk assessment of their membership within the CMS deadlines. Our accuracy in coding allows our clients to maintain the balance between submitting what can be appropriately claimed and avoiding penalties for inaccurate data.

This includes:

  • Retrospective and Prospective Chart Reviews
  • Coding to the highest specificity, based on the provider documentation, to maximize risk scores and reporting missed codes
  • Certified/clinical coders (CPC & CCS) for in-depth focused chart review
  • Validate documentation on all diagnosis codes in chart and codes hitting HCCs and highlight documentation errors

Our clients have not only received the benefit of cost while using our HCC review services, they have also seen an improvement in overall RAF scores.

Client Thoughts

"The dedication from our e4e teams to provide the best possible services is beyond comparison."

"We are amazed and pleased with…the difference the e4e team is making to our inventory levels."

"All work being performed by you is good and very well appreciated."

"We really appreciate all that you do to help make us a better company and increase our business's revenue."

"e4e continues to be a key player in the success of our company."

"They are very accurate in their work and are very responsive to our changing needs."

"By utilizing your services, we are able to focus more on our client and strengthen our core delivery."

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Provider Solutions

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