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Validating and resolving Complex DRG coding errors resulting in accurate billing and reimbursement
Thorough Audit process to counter inaccurate and incomplete coding in Outpatient services
Validating all claims and securing prompt recovery in the universe of Nursing care
WHO ARE WE
We tailor each auditing process to meet our client’s unique strategic objectives, and employ innovative and forward-thinking solutions to meet their auditing, compliance and recovery goals.
(Chairman and founder)
Identify existing coding and documentation issues that may affect your organization’s revenue or put your organization at risk for compliance violations. AIE can provide the gold-standard in a comprehensive assessment of documentation, coding and billing.
Verify compliance and validate documentation and coding to avoid inaccurate risk adjustment or underpayments with an expert HCC audit. We utilize a structured methodology designed to validate the accuracy of diagnosis coding related to HCC categories and determine whether or not records meet CMS’s compliance requirements.
Validate the accuracy of audit findings for repayment requests. By objectively applying CMS & CPT coding principles and guidelines, we reveal errors in the original review and reduce your repayment amounts. Additionally, our experts will identify areas where a physician’s work is not being accurately reflected in the documentation. Then, through education and documentation tips, your providers can better translate their thought processes into more accurate coding and claims submissions.
Capitalize on overlooked opportunities for improvement, around multiple service lines within your healthcare system or facility by implementing best practice policies and procedures. AIE can provide expert outpatient CDI assessment, program development, training and ICD-10 clinical documentation audits.
Detect payment variances, flag underpaid and incorrectly closed claims and identify inappropriate denials and rejections. At no upfront cost to clients, AIE provides an underpayment recovery service that helps hospitals and health systems quickly recover your dollars, enhance your revenues and keep your financials healthy.
Together, we’ll decide on a custom solution for your organization’s unique problems. Our highly-trained auditors conduct over 125,000 audits annually. Clients range from solo practice physicians to large integrated health systems and academic medical centers. We match the expertise of each auditor by medical specialty and conduct multi-tier reviews on every audit to ensure your findings are accurate and, best of all, save you time and money.
MEET OUR TEAM
MBBS
MBBS, MD
CIRCC, CPC
CPC
Our unique process focuses on obtaining signed agreements that minimize friction and improve your bottom line.
Our Unique Process
AI Revenue Integrity proved to be the best vendor due to their knowledge and understanding of the Epic system. We were challenged to find certified skilled coders within our region and AI Revenue Integrity fit the bill. They have AHIMA and AAPC certified coders that were able to provide insight when we transitioned to the Epic system which was extremely beneficial. They always go the extra mile and are a true strategic partner.”
– Controller, Level III Stroke Hospital