Accurate charge entry from provider documentation, plus payer-specific claim review — catching CPT, ICD-10, modifier, and place-of-service issues before they come back as denials.
Provider's notes → practice management system.
Codes match the documented service and diagnosis.
Telehealth, laterality, distinct-procedure, and payer-specific modifiers applied correctly.
Critical for telehealth, home visits, mixed office/facility schedules.
Plan rules that vary between payers get applied before submission.
For injectable and infused medications.
Services documented but not billed get flagged and captured.
Most denials are preventable at the front end — a missed modifier, a POS that doesn't match the payer's telehealth policy, a diagnosis code that doesn't support medical necessity. Catching them before the claim leaves the door is dramatically cheaper than fixing them after. This feeds directly into your clean-claim rate, days-in-A/R, and how predictable your cash flow is.
A note on coding: Charge entry & claim review focuses on accurate application of codes captured by the provider and preventing payer-specific submission errors — not on providing professional coding services. If a practice needs a certified professional coder, we'll say so and coordinate.
De-identified aging only · No obligation · Bilingual (English & Spanish)
Share a de-identified A/R aging report and we'll review your outstanding balances, aging trends, payer patterns, and recovery opportunities — at no cost and with no obligation.