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Your Medical Review Partners



Billing and Coding Compliance Services


Billing Compliance


We offer expert and independent medical billing audits to clients wanting to ensure that charges match actual care and services delivered.

In most cases, our nurse reviewers and coding specialists focus on predetermined targets based on procedure and diagnosis, or cost and day parameters. Our vast experience analyzing public and private health care claims can assist you in establishing and maintaining audit targets.

Permedion's external medical billing audit services are provided on a continuous schedule or on an as-needed basis. Throughout the billing audit process, we take great care to ensure confidentiality of all patient records.



Encounter Data Validation


Consistent and accurate documentation of rendered services is important for billing purposes as well as rate setting, utilization management, and quality measurement. Organizations receiving capitated payments do not have a direct financial incentive to report accurate and complete encounters to payors. Therefore, encounter data may not always be of value. Our experience with encounter data validation helps ensure high-quality data to support vital managed care functions.

Our encounter data validation studies have assessed quality and completeness of data from inpatient, outpatient, and physician office settings, and typically include action plans for improvement among providers.



Coding Compliance


Permedion's credentialed health information and coding specialists help you understand and comply with reimbursement rules and requirements. Services that support our clients' efforts to stay current and compliant in a dynamic environment include:


Regular reviews of billing and supporting medical record documentation to assess compliance and identify potential problems.
Training of coding personnel, physicians, nurses, and other clinical staff regarding government payer billing and documentation requirements
Development of policy and procedure manuals


ICD-9-CM and CPT coding audits help providers and practitioners of all sizes to appropriately assign procedure codes, reduce upcoding liability, and mitigate denials and suspensions.
External and independent coding compliance services and medical billing audits by Permedion.



For More Information or Pricing


Please call Dennis Gramlich at (800) 473-0802 or contact us electronically. Go


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