Medical Chart Reviews
Identify and remedy vulnerabilities — before they become liabilities.How AAPC can help your organization
AAPC Medical Chart Review Services begin with a meticulous comparison of documentation to billed codes — and ends with helping you achieve accurate, liability-free coding that captures maximum reimbursement. Our comprehensive chart audit reviews will:
Identify areas of potential risk
Minimize claim denials and provider appeals
Defend against federal and payer audits
Ensure proper documentation that supports reported services
Discover overpayments and protect against false claims liability
Identify undercoding and reimbursement deficiencies
Improve your clean claims rate
Reduce rework and drive efficiency
Expertise for your organization
We provide prospective and retrospective multi-tier chart reviews conducted by a team built for your specialty, patient population, and place of service. Our expertise includes, but is not limited to:
Pro-fee chart reviews
40+ specialties
80+ sub-specialties
Hospital-based provider pro-fee visits
Emergency department visits
Hospital/inpatient facilities
Acute care
Behavioral health
Skilled nursing facilities
Hospice and home health
MS-DRG
APR-DRG
ASC/hospital outpatient
APC, surgical CPT®
Same-day surgery
Interventional procedures, injections, and infusion
Observation visits and diagnostic testing
Emergency department E/M
You're in good company.
Trust and transparency with chart review technology
Our high-impact technology identifies upwards of 10% (on average) in missed revenue. When combined with our deep expertise, your organization is assured maximum financial gain in a streamlined process — that you can track from start to finish.
Customized Medical Chart Review Services
Focused Medical Chart Review
Our focused chart reviews provide reliable data to remedy claim issues involving sequencing, modifiers, or E/M reporting. Our focused audits target high-impact areas, such as:
Payer-focused reviews
Provider-focused reviews
Coder-focused reviews
Guideline-focused reviews
Medical necessity
CERT-identified/trending errors
Missed diagnosis codes
High RVU services
High volume services
High denial services and denial patterns
Undercoding
OIG and RAC target areas
Payer-Required Medical Record Review
In addition to taking on payer-required reviews, we also conduct preliminary reviews that improve accuracy for stronger negotiating leverage and a better financial arrangement with your payers.
Comprehensive Chart Review
Our comprehensive medical record reviews examine your coding and clinical documentation to identify errors and prevent denials at their points of origin.
Audit. Educate. Re-audit.
Post-audit education and training is paramount to success. We can help your team improve reporting accuracy and keep pace with evolving regulations and payer guidelines. Based on your audit data, we work with your coding educator or directly train your clinicians and coding staff.
Your End-to-End Medical Chart Review Solution
We offer full-scale chart audit programs customized to your organization. When you rely on AAPC Services, you get subject matter experts with third-party objectivity, delivering optimal results:
Maximum reporting accuracy
Heightened productivity
Reduced A/R days
Unparalleled financial growth
DRG Validation Chart Review
Reduce DRG downgrades and denials. Our DRG validation audits will review your cases to ensure they're correctly coded, sequenced, and supported in the medical record.
Outcomes
A chart review program capable of reducing risks includes written policies that define reporting standards, as well as audit guidelines. We can assess your policies to ensure that controls are effective. Your dedicated audit team will be on hand to help you:
Determine if your policies are current and effective
Identify vulnerabilities in your audit plan
Draft controls to close compliance gaps
Explore issues related to electronic medical record templates
Investigate recurring problems, particularly root cause processes
Implement corrective actions, industry standards, and best practices
What sets our chart review services apart?
AAPC Services is a full-service organization with a reputation for excellence. Our track record of success is paved by medical auditors with vast experience and multiple certifications in coding, specialty coding, auditing, CDI, and healthcare compliance. And when it comes to the accuracy you depend on, we leave nothing to chance. Our quality committee evaluates every audit, as well as every auditor.
