Billing Integrity
Billing Integrity
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What We Do
Pre-Bill Documentation Review (Prospective CDI)
We evaluate documentation before claims drop to ensure E/M accuracy, ICD-10 specificity, and medical-necessity compliance.
Post-Bill Coding Accuracy Audits
Independent, unbiased audits of all inpatient specialties to identify coding errors, missed revenue, and compliance risks.
Denial Management & Prevention
TNM uncovers the true root causes of denials and implements corrective strategies that reduce recurrence.
Physician Education & Coaching
Special specific ty-training improves documentation accuracy and strengthens provider confidence.
Executive-Level Reporting & Analytics
Risk dashboards, accuracy scores, denial trends, and leadership-ready reports provide transparency and strategic clarity.
Accuracy Review
Keep it short, three chips or cards.
Built for
Documentation pattern analysis
Predictive denial modeling
CDI query recommendations
Provider risk scoring
Systemwide pattern detection
Revenue integrity map
Where integrity breaks and revenue leaks
We prioritize fixes by financial impact, compliance risk, and speed to correct, then track performance month over month.
Services
Medical Coding
Coding alignment, modifier accuracy, and variance reduction across service lines.
- DRG audits
- Query support
- Trending
DRG Validation
DRG validation and case mix integrity review to reduce reimbursement risk and improve accuracy.
- DRG audits
- Query support
- Trending
Clinical Documentation Integrity
CDI workflows that improve documentation quality, reduce denials, and strengthen coding accuracy.
- Query workflows
- Provider enablement
- KPI tracking
Documentation Compliance
Documentation compliance checks and audit readiness support aligned to payer and regulatory expectations.
- Risk flags
- Audit prep
- Standard work
Denials Reduction and Appeals
Denial taxonomy, root cause fixes, and appeal playbooks that reduce repeat denials.
- Denial drivers
- Appeals workflow
- Trending
Underpayment and Payment Integrity
Underpayment detection, contract variance review, and recovery workflow with reporting.
- Variance flags
- Recovery tracking
- Scorecards