Our Coders & Auditors

All of our coders are single-specialty coders and must:
  • Be certified by either AAPC, RCCB, AHIMA and/or ACMCS
  • Have a minimum of 3 years of single-specialty coding experience
  • Live and work in the United States
  • Pass an internal coding skills assessment examination
  • Keep their coding certifications current by continuing their professional education
  • Stay abreast of coding and regulatory changes and issues identified in our internal compliance audits
  • Attend a variety of compliance education courses every year

All of our auditors are single-specialty auditors and must:

  • Be certified by either AAPC, RCCB, AHIMA and/or ACMCS
  • Have a minimum of 5 years of single-specialty auditing and coding experience
  • Live and work in the United States
  • Pass an internal coding skills assessment examination
  • Keep their coding certifications current by continuing their professional education
  • Stay abreast of coding and regulatory changes and issues identified in our internal compliance audits
  • Attend a variety of compliance education courses every year

The Coding Network also monitors all of its coders via our comprehensive compliance program.  Each quarter:

 

  • Every coder has a random sample of charts reviewed by our internal Q/A reviewer
  • Each coder must demonstrate a 90% accuracy rate or undergo remediation
  • In the event of remediation, the coder must achieve and maintain a 90% accuracy rate or face dismissal

 

All results of our chart review are recorded for compliance purposes.  Additionally, our coding staff is often reviewed by the Compliance Offices of many of our clients as part of their own compliance review programs.

(For multiple specialty clients, where different single-specialty coders will be utilized, The Coding Network will assign a team leader to manage the account. Team leaders become the operational liaisons that coordinate each coder’s contributions with the client to facilitate easy and effective communication with the coding/auditing team supporting that client.)

 

Latest Blog Posts:

Florida Physicians and Practice Settle False and Fraudulent Claims Case

June 18th, 2019|Comments Off on Florida Physicians and Practice Settle False and Fraudulent Claims Case

Jaime L. Sepulveda, MD, LLC (d/b/a Miami Urogynecology Center), Jaime L. Sepulveda, M.D., and Sujata Yavagal, M.D. (collectively, "Miami Urogynecology Center"), South Miami, Florida, entered into a $173,768.08 settlement agreement with OIG. The settlement agreement [...]

Connecticut Diagnostic Services Provider Settles Case Involving False Claims

June 14th, 2019|Comments Off on Connecticut Diagnostic Services Provider Settles Case Involving False Claims

On November 19, 2018, Southern Connecticut Vascular Center, LLC (SCVC), Stratford, Connecticut, entered into a $792,076.76 settlement agreement with OIG. The settlement agreement resolves allegations that SCVC submitted claims for Healthcare Common Procedure Coding System (HCPCS) [...]

California Physician and Practice Settle Case Involving False Claims

June 14th, 2019|Comments Off on California Physician and Practice Settle Case Involving False Claims

On December 20, 2018, Michael Jadali, D.O., and the Center for Pain & Rehabilitation Medicine (collectively, "Dr. Jadali"), San Jose, California, entered into a $60,406.30 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. [...]

California Physician and Practice Settle False and Fraudulent Claims Case

June 13th, 2019|Comments Off on California Physician and Practice Settle False and Fraudulent Claims Case

On April 12, 2019, Complete Women Care, Inc., and Miriam Mackovic-Basic, M.D. (collectively, "CWC"), with multiple locations in Los Angeles County, California, entered into a $258,045 settlement agreement with OIG. The settlement agreement resolves allegations that [...]