Medical Coding Compliance Department Support


Many multispecialty healthcare systems, academic faculty practices, and large medical groups have established central Compliance Offices, usually staffed with small number of coders. They are responsible for compliance reviews of all of the many specialties and subspecialties represented by the practice’s physicians. Considering the unique clinical characteristics of each specialty and the complexity and differences of the coding rules and regulations between the various specialties, we are absolutely convinced that it is virtually impossible for one person to know it all. The fund-of-knowledge encompassing the totality of medicine is simply too vast. This is why physicians specialize, and is the very same reason why we organized The Coding Network along a similar specialty-driven structure. Experience has taught us, over and over, that matching the coder/auditor’s expertise to a specific specialty is the only way to assure maximal accuracy and compliance.

We can support your Compliance Office’s efforts very economically. Our audit findings have the additional credibility of being from an outside independent firm with specialty-specific expertise. Your employed compliance staff can then focus their energy and resources on working one-on-one with each provider to improve the quality of their medical record documentation. This totally changes the dynamics of the provider-compliance relationship from one of adversarial “policing” to into one of teamwork to reduce legal risks and optimize revenues.

With our accuracy guarantee coupled with no monthly or annual minimums or “subscription fees,” we can cost-effectively support your Compliance Officer with no fixed expenses!

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Liberty Ambulance Service investigated for fraudulently billing federal agencies

July 12th, 2018|Comments Off on Liberty Ambulance Service investigated for fraudulently billing federal agencies

Liberty Ambulance Service, located in Jacksonville, has agreed to a $1.2 million settlement. This is in response to allegations that it, for more than 10 years, fraudulently billed federal health benefits providers for transportation of patients.

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Allstate Files $2M Suit

July 9th, 2018|Comments Off on Allstate Files $2M Suit

Allstate, one of the largest insurance companies in the world, has filed 81 fraud lawsuits in New York since 2003. Most recently, the company filed another suit against 13 new corporations. This has been an attempt […]

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Sanford Health to expand into Chicago market

July 6th, 2018|Comments Off on Sanford Health to expand into Chicago market

Five years after South Dakota-based Sanford Health failed to acquire Minneapolis-based Fairview Health Services, the 45-hospital system is looking to expand outside of state lines for the second time and eyeing potential opportunities in Chicago.

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FWC Urogynecology Agrees To Pay $1.7 Million in Settlement

July 6th, 2018|Comments Off on FWC Urogynecology Agrees To Pay $1.7 Million in Settlement

US Attorney Maria Lopez announced that FWC Urogynecology, LLC, in Florida, has agreed to pay the US $1,700,000.00 to resolve allegations that it violated the False Claims Act by knowingly billing the government for services […]