Medical Reviews

Precision provided Medical Reviews. Medical Clinical claims reviews identify medical necessity, coding (including by not limited to ICD-10CM ICD-10PCS, CPT, Diagnosis Related Group-DRG validation, and Ambulatory Patient Groups-APGs), level of service and reimbursement errors by comparing claims against medical records. We provide Prospective and Retrospective reviews.

Our team of clinicians and certified coders include the following certifications:

MD’s, PhDs, PAs, NPs, RNs, HealthCare Attorneys
HealthCare Certified Consultants
CCS-P (Certified Coding Specialist- Physicians) *
CCS (Certified Coding Specialist) *
ICD-10CM PCS Certified Trainer *
CPC (Certified Procedural Coder) **
CPC-I (Certified Procedural Coder-Instructor) **
CHIT-IM (Certified Health Information Technologist *
RHIA - Registered Health Information Administrator *

RHIT – Registered Health Information Technician *

CDIP – Clinical Documentation Improvement Professional *

HCC Risk Adjustment Coder **

Certified FourSight Assessment

Certified Agility Training

Harvard Graduate – Human Development

Center for Creative Leadership (CCL)

Center for Medicare and Medicaid Services (CMS) Vendor for CAPHS

doctor at desk

*American Health Information Management Association – AHIMA Certification
**American Academy of Professional Coders – AAPC Certification

We ease your administrative burden, increase provider cooperation, ensure fewer appeals and deliver savings quickly. We perform high-quality reviews within prompt-pay guidelines, with an accuracy rate that consistently exceeds CMS requirements.