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Compliance and Documentation Audits
Services Offered
Billing and Coding Reviews
Practice Evaluations/Assessments
A Compliance and Documentation Review is provided to determine if physicians and other practitioners are coding evaluation, management and other services correctly. A representative sample of the documentation is audited and recommendations are made to assist with coding more appropriately. Training can be provided to assist practitioners with this complex process. Documenting correctly is critical to accurate payment and compliance with all insurance payers. This can avoid refunds or penalties by the payer and investigation by the Texas Medical Board.

Billing and Coding Review is done to determine if the billing and front office staff is efficient in maximizing the collection of revenues. It will also determine if the practice is following Medicare, Medicaid, and other payer’s guidelines for appropriate, medically necessary billing and coding. Efficiency in coding and billing allows for higher revenue generation.
A Practice Evaluation is an operational and financial study of an existing medical practice. This evaluation provides a comparative analysis to other practices of the same specialty. Encounter or case data is reviewed and compared as well as financial ratios. Staff efficiency and workflow is another major component as is review of the reimbursement area. This review allows the practice to obtain a snapshot of where it is at the present and what needs to change to operate successfully. 
Managed Care Contract Negotiation
Staff Recruiting and Human Resource Management 
Contract Review and Negotiation Services is designed to maximize revenue for the practice by identifying insurance carriers with unfavorable fees and determining opportunities for negotiation. Better fees allow the practice to maintain overhead and generate more revenue.
Programs designed to assist practices with recruiting quality staff for their office. High quality staff is vital to a practice’s success
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