Medical Coding & Billing Services

Our CPC, CCS, and RHIA-certified coders deliver accurate, compliant coding across 30+ specialties. We handle inpatient, outpatient, professional fee, and facility coding — ensuring every diagnosis and procedure is captured correctly for maximum reimbursement.

• ICD-10-CM & ICD-10-PCS diagnosis and procedure coding
• CPT and HCPCS Level II procedure coding
• E&M level assignment and documentation review
• Specialty-specific coding (cardiology, ortho, radiology, oncology & more)
• HCC risk adjustment coding for value-based care
• Prospective & retrospective coding reviews

From charge capture to final payment, our billing specialists manage the entire revenue cycle. We work with all major payers — Medicare, Medicaid, commercial insurers — and ensure claims are submitted clean, on time, and in full compliance.

• Charge entry and fee schedule management
• Electronic and paper claim submission
• Medicare, Medicaid & commercial payer billing
• Patient statement generation and follow-up
• Eligibility verification and pre-authorization support
• Real-time claim status tracking and reporting

Our rigorous pre-submission audit process catches errors before claims reach the payer. Every claim is scrubbed for coding accuracy, payer-specific edits, and compliance — resulting in a 98% clean claim rate and dramatically fewer rejections.

• Pre-submission claim scrubbing and validation
• Payer-specific edit checks and compliance review
• Electronic remittance advice (ERA) processing
• Claim rejection analysis and resubmission
• Secondary and tertiary claim filing
• Coordination of benefits (COB) management

Denied claims represent lost revenue. Our denial management team performs root-cause analysis on every denial, files timely appeals, and implements systemic fixes to prevent recurrence — recovering revenue and protecting your bottom line.

• Denial categorization and root-cause analysis
• Timely appeal filing with clinical documentation
• Payer-specific appeal strategy development
• Denial trend reporting and prevention planning
• Underpayment identification and recovery
• Payer contract compliance review

Aging AR is a silent drain on cash flow. Our AR specialists proactively follow up on outstanding claims, prioritize high-value accounts, and work aging buckets systematically — keeping your days in AR low and collections high.

• Systematic follow-up on all outstanding claims
• Aging bucket prioritization (30/60/90/120+ days)
• Payer-specific follow-up protocols
• Patient balance follow-up and collections support
• Monthly AR aging reports and dashboards
• Write-off analysis and bad debt management

Accurate payment posting is the foundation of clean financial reporting. We post EOBs, ERAs, and patient payments with same-day turnaround, identify contractual variances, and flag underpayments for immediate follow-up.

• Electronic remittance (ERA) and manual EOB posting
• Patient payment and co-pay posting
• Contractual adjustment and write-off posting
• Variance analysis and underpayment identification
• Reconciliation of deposits and bank statements
• Same-day posting turnaround SLA

Our comprehensive coding audits identify compliance gaps, documentation deficiencies, and revenue leakage before they become costly problems. We provide detailed findings, coder education, and actionable remediation plans.

• Prospective and retrospective coding audits
• E&M documentation and coding accuracy review
• Specialty-specific audit programs
• OIG compliance and risk assessment
• Coder education and feedback sessions
• Written audit reports with remediation plans

Every engagement with REVONIQ Healthcare is backed by a signed Business Associate Agreement (BAA) and strict HIPAA protocols. Our infrastructure, workflows, and staff training are designed to protect PHI at every touchpoint.

• Signed Business Associate Agreement (BAA)
• End-to-end PHI encryption in transit and at rest
• Role-based access controls and audit trails
• Annual HIPAA training for all staff
• Incident response and breach notification protocols
• Regular security risk assessments