CHAN HEALTHCARE

Coding/Compliance

Compliance Experts
CHAN Healthcare has several full-time auditors who work exclusively on corporate compliance matters. These compliance specialists are much more than a technical resource for our clients and auditors. They develop innovative risk assessment tools, communicate information on emerging issues, develop audit programs for high-risk compliance areas, and monitor adherence to corporate integrity agreements. CHAN Healthcare's Director of Coding Compliance also reviews each client's annual audit plan to ensure appropriate attention has been given to compliance risks.

Coding and Billing Experts
In addition to our client-based auditors, many of our clients have dedicated CHAN Healthcare coding compliance auditors who perform in-depth technical reviews of their coding and billing procedures. These individuals have special training and experience that qualify them to assess coding accuracy and CPT, ICD-9, and DRG assignments on an account-level basis.

Compliance Assessment
Healthcare organizations have an increasing need to maintain effective compliance programs. CHAN Healthcare can develop benchmark indicators to assess the effectiveness of corporate compliance programs, and perform audits to evaluate compliance with the indicators.

Our Coding Compliance services include:

Inpatient Coding Reviews
Behavioral Health, Diagnosis Related Groups (DRGs), Inpatient Rehabilitation, One Day Stays, Same Day Readmissions, and Transfer/Discharge Status

Outpatient Coding Reviews
Ambulatory Payment Classifications (APCs), Ambulatory Surgical Centers (ASCs), Behavioral Health, Cardiac Catheterization, Evaluation and Management (E/M) Services, Inverventional Radiology/Cardiology, Observation, and Therapies

Physician Coding Reviews
E/M Services in both the hospital and clinic setting, "Incident To" Services, Mid-level Provider Services, and Teaching Physician Documentation Requirements

Specialized High-Risk Services
Home Health, Hospice, and Skilled Nursing Facilities