Medical Coding and Documentation Services

The AGS Health global coding team receives detailed, specialty-specific training that ensures excellent quality levels and clean claim submissions. Our proven implementation process is seamless and includes effective controls to ensure minimal disruption – all with 3-4x ROI.

Beyond the ROI, our continuous focus on coding quality and compliance eliminates the headaches that many of our customers experience when onboarding new staff.

AGS offers professional fee services for the following settings:

• Emergency visits
• Multi-specialty – E/M
• Hospital medicine
• Ambulatory surgery 
• Anesthesiology
• Ambulance
• Pathology and lab
• and more…

Our dedicated team of coders, receive extensive training and possess a minimum of a bachelor’s degree in a healthcare-related field. Our rigorous focus on coding quality and compliance is regulated by a dedicated compliance task force and robust quality management controls.

We also offer an extensive suite of reports and high-impact analyses for inpatient coding, including thorough investigations of CDI mismatches, physician queries, MS-DRG vs. APR-DRG, GM-LOS vs. actual LOS, and more.

AGS offers hospital facility coding services for the following needs:

• Inpatient
• Emergency department
• Same-day surgery
• Observations 
• Urgent care
• Ancillaries

Leveraging Hierarchical Condition Category (HCC) coding can help healthcare organizations ensure appropriate payment for services among populations experiencing serious or chronic illness. However, this also adds a new layer of complexity to documentation and coding processes.

Our highly trained staff can assist with the coding of complex cases for risk adjustment and provide a more complete picture of the patient. We will also work with you to ensure documentation complies with HCC reporting requirements for maximum reimbursement.

To support complex coding, AGS Health will:

• Conduct high-accuracy diagnostic coding.
• Ensure medical records are complete and accurate based on Hierarchical Condition Categories (HCCs) guidelines.
• Verify risk-adjusted codes and documentation based on industry standards.
• Provide assessment of documentation based on M.E.A.T. criteria.

Proper coding requires meaningful documentation that is complete, accurate, and consistent. A properly configured clinical documentation integrity (CDI) program can help achieve this goal and drive greater revenue outcomes for your organization.

You can count on the AGS Health team to provide retrospective and concurrent reviews of clinical documentation. We will help you identify missing information, place physician queries, and recommend improvement opportunities to ensure your documentation is ready for coding.

The AGS Health CDI program provides:

• Concurrent reviews of medical records to ensure timely filings.
• Timely physician queries to obtain necessary clarifications or corrections for accurate coding.
• Follow up on previously unanswered queries or delayed answers.
• Assignment of the correct POA status.
• Education on documentation best practices and requirements for physicians.

Code volumes and complexity are continuously growing and will continue to do so with the adoption of ICD-11. As result, coding errors have become one of the top sources of denials.

With AGS Health, you can rest assured that our team will thoroughly review codes, flag any issues, and perform prompt resolution to ensure timely and accurate claim submissions and appeals.

Our team of service experts can help you:

• Rapidly identify coding errors.
• Perform necessary coding edits.
• Manage appeals for both professional and hospital coding.

Public and private payer audits are on the rise, resulting in lost revenue, heavy fines, and damaged reputations. To protect your organization and its hard-earned revenue, it’s critical to perform code audits with a partner you can trust.

By leveraging our auditing team for complete coding compliance audits, you can have confidence in the accuracy, quality, and reimbursement of your claims.

AGS Health offers auditing services for:

• Inpatient
• Outpatient
• Professional
• Value-Based Care audits including mortality and MIPS