LexiCode Consulting Audit Services

Consulting Services

Healthcare providers today are faced with significant financial and resource challenges. LexiCode, an Exela company, offers a board range of HIM coding and consulting solution as well as expertise in the healthcare market to meet your needs. Our 35+ years of success in all healthcare settings has been built upon the delivery of high quality HIM/coding solutions utilizing only seasoned AHIMA credentialed professionals.

Compliance and Reimbursement Audits

Value of Compliance and Reimbursement Audits:

• Identifies revenue opportunities (underpayments)
• Ensure compliance (overpayments, non-compliance with coding guidelines)
• Identifies root causes of coding issues: coder error, physician documentation, workflow
• Coder feedback is reviewed and discussed prior to finalization
• Flexible scheduling without a resource commitment
• Auditors are experts in the industry, credentialed, with years of experience
• Ability to work in any EHR or with other non-EHR solutions
• Robust deliverables, including detailed trend reporting, coder/provider education, solid recommendations
• Internal quality assurance ensures second level review of recommendations

We will work collaboratively with your team in each phase (pre-audit, audit, post-audit) to ensure the process is efficient and organized.

Types of audits:

• MS-DRG/CMS-DRG/AP-DRG
• APR-DRG
• Comprehensive Inpatient Coding Audits
• Outpatient Coding Audits
• Professional Fee/Physician-Based Audits – Evaluation & Management, Surgical Encounters
• Specialty Audits
  • Long Term Acute Care (LTAC) – comprehensive or DRG validation
  • Behavioral Health/IPF-PPS
  • Rehabilitation Audits/UB-04 post discharge/IRF-PAI coding:
  • Skilled Nursing Facilities
• HCC (Hierarchical Condition Category)/RADV Coding Audits