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Compliance Services

Are you sure that your patient encounters are being documented accurately?

Medical coding is a complex and high-risk endeavor. Edelberg can help identify best practices for you an your organization that helps mitigate risk and provide greater visibility to the efficacy of your medical coding operations.

Today’s healthcare organizations find themselves in an unfortunate scenario of increasing costs, complexity and regulatory requirements against a backdrop of federal and commercial payor programs that are trying to find any way to lower the ever-rising cost of healthcare.

One of the mechanisms in use is the RAC Audit vehicle and audits like these are on the rise with no end in sight.
If you or your organization has ever been involved in a RAC audit then you will know that these audits focus on extrapolated recoupments and penalties that are sometimes difficult to understand and even harder to defend.

Edelberg & Associates offers our expertise and cumulative years in the trenches to organizations that wish to confirm the findings of a RAC Audit before simply capitulating and paying them. For a reasonable fee, Edelberg & Associates will spend time with your organization to understand the audit findings and to help eliminate or reduce the large check that is invariably involved in these types of initiatives.

Our experience through hundreds of RAC audit defenses tells us that the RAC Auditors themselves are often times not intimately familiar with the specialty and are quick to indicate or assert coding errors when in fact this may not be the case. Edelberg & Associates RAC Audit defense and assistance engagements are designed to provide a comprehensive base of knowledge to provide you with the information and tools you need to rightfully defend unwarranted or erroneous penalties.