Synopsis
In today’s regulatory-heavy landscape, payers are increasing audits, and coding errors can lead to serious consequences, ranging from denied claims to compliance penalties and revenue leakage. Internal audits are often insufficient to detect systemic issues and trends that affect long-term reimbursement and compliance.
Orgusta’s Medical Code Auditing Services provide end-to-end auditing solutions that verify the accuracy of coding, assess compliance with regulatory standards, and uncover revenue opportunities. Our expert auditors leverage deep industry experience, data analytics, and structured audit processes to minimize risks and maximize reimbursement accuracy
Audit Excellence: Methodologies for Maximum Impact
Apply random and targeted sampling techniques for high-risk areas
- Conduct audits in alignment with ICD-10, CPT/HCPCS, and payer-specific guidelines
- Perform root cause analysis on errors and discrepancies to identify trends
- Deliver actionable audit reports and dashboards for transparency and strategy
- Provide education and training sessions for coders and physicians based on findings
Delivering Financial and Operational Value
📉 20–30% improvement in revenue recapture through corrected coding and underpayment identification
⏱ Reduced risk exposure to payer takebacks and audits
🎯 98%+ audit accuracy rates, supporting compliance and reducing error recurrence
🛡️ Enhanced clinical documentation and improved provider engagement
💰Proactive coding quality assurance for long-term revenue cycle optimization
