Accurate coding is the backbone of successful revenue cycle management. AllegianceRCM ensures compliance, accuracy, and efficiency in medical coding to minimize denials, maximize reimbursements, and meet evolving regulatory requirements. Our certified coders specialize in ICD-10, CPT, and HCPCS coding, offering expert-driven solutions that streamline your workflow and protect your practice from audits and revenue losses.
Medical coding errors lead to denied claims, lost revenue, and compliance risks. At AllegianceRCM, we ensure meticulous code selection and claim submission to prevent errors and maintain financial integrity. Our certified coding professionals stay updated with Medicare, Medicaid, and private payer guidelines to ensure your practice remains compliant and audit-ready.
How We Help You Succeed?
Different specialties demand unique coding expertise. AllegianceRCM’s certified coders specialize in a wide range of disciplines, ensuring correct procedural and diagnosis coding for optimal reimbursement. Whether it’s surgery, cardiology, neurology, or behavioral health, we ensure your coding reflects the complexity of care provided.
Accurate coding in primary care and internal medicine is essential for maximizing reimbursements and ensuring compliance. E/M coding (99202–99215) plays a critical role, requiring precise documentation to determine levels of service. Chronic care management (99490), annual wellness visits (G0438–G0439), and HCC risk adjustment coding are crucial for value-based care. Proper use of diagnosis specificity in ICD-10 and adherence to payer guidelines minimizes denials and supports accurate claim submissions.
Cardiology, orthopedics, and surgical specialties require detailed procedure coding (CPT 10000–69990), correct modifier application, and global period tracking to ensure clean claims. Interventional cardiology (92920–92928), orthopedic procedures (20610, 29881), and surgical coding for bundled payments demand compliance with CMS and payer-specific guidelines. AllegianceRCM ensures accurate procedural documentation, reducing downcoding, bundling errors, and claim denials for higher reimbursements.
Behavioral health and neurology coding involve time-based E/M codes (99204–99215), psychotherapy (90832–90837), and neurophysiological testing (95950–95957). Complex coding rules for autism spectrum disorder (90785), substance use treatments (H0001–H0049), and mental health parity compliance require precision to avoid claim denials. AllegianceRCM ensures proper documentation, reduces medical necessity denials, and improves reimbursement rates for behavioral and neurological services.
Coding for OB/GYN and pediatrics involves preventive care, maternity services (CPT 59400–59510), and contraceptive management (11981, 57170). Pediatric services include vaccination coding (90460–90461), well-child visits (99381–99395), and developmental screenings (96110). AllegianceRCM ensures adherence to global maternity billing rules, payer policies, and age-specific documentation requirements, reducing denials and optimizing revenue for women’s and children’s health providers.
Emergency and urgent care coding require rapid ICD-10 specificity, trauma coding (99291–99292 for critical care), and procedural accuracy (CPT 31500 for intubation, 36415 for venipuncture). Proper documentation for laceration repairs (12001–13160), fracture care (29000–29799), and diagnostic services (93000 for ECGs, 71045 for X-rays) is vital to avoid downcoding or upcoding errors. AllegianceRCM streamlines emergency medical coding, reducing denials and improving reimbursement speed.
Regular coding audits help identify underbilling, overbilling, and compliance risks. AllegianceRCM conducts thorough chart reviews and coding accuracy assessments to prevent coding errors that lead to revenue leakage or payer penalties. We ensure coding aligns with clinical documentation and meets the latest regulatory standards.
How Our Audits Improve Compliance:
Denied claims often result from incorrect coding, missing modifiers, or medical necessity issues. Our coding specialists work with denial management teams to analyze, correct, and resubmit claims efficiently. We provide root cause analysis and education to prevent future denials, helping your practice improve clean claim rates and cash flow.
Proactive claim scrubbing and pre-submission checks ensure coding accuracy, reducing errors before submission. Our system identifies missing modifiers, incorrect codes, and documentation gaps, preventing denials and rejections. By ensuring compliance with payer-specific rules, we maximize clean claim rates and timely reimbursements.
Denied claims often result from coding errors, bundling issues, or incorrect procedures. Our team quickly identifies the cause, corrects discrepancies, and resubmits claims for faster reimbursement. We follow payer guidelines to prevent recurrent denials and optimize revenue recovery.
When coding-related denials occur, strategic appeals help recover lost revenue. Our experts draft detailed appeal letters, providing supporting documentation and medical necessity proof to overturn denials. With structured follow-ups, we ensure timely resolution and maximum reimbursement success.
AllegianceRCM goes beyond standard coding services by leveraging analytics and AI-driven insights. Our custom reporting tools help track coding trends, compliance risks, and opportunities for revenue improvement. We also provide educational support for providers to ensure accurate documentation and coding consistency.
AllegianceRCM delivers accurate, compliant, and efficient coding solutions to enhance revenue integrity, reduce denials, and keep your practice audit-ready. Our expert-driven approach ensures that your claims are coded correctly the first time—boosting cash flow and protecting your practice from regulatory risks.
We are technology agnostic and have worked on all modern SaaS based electronic medical records and practice management systems. The following is a list of most common practice management systems used across the industry and extensively used by us. If you don’t see your EHR here, please contact us.
AllegianceRCM is a trusted leader in revenue cycle management, delivering tailored solutions for healthcare providers, including independent practices, specialty groups, and urgent care centers. Our expertise in medical billing, coding, denial management, and credentialing ensures streamlined operations and maximized reimbursements. With a commitment to transparency, cutting-edge technology, and personalized service, we empower providers to focus on patient care while achieving financial success. At AllegianceRCM, your practice’s growth is our priority.
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