Healthcare Compliance & Revenue Integrity Advisory for Risk Adjustment and AI Governance
We help healthcare organizations evaluate risk adjustment and coding practices, govern AI-assisted workflows, and strengthen revenue integrity—ensuring all diagnoses, processes, and decisions are accurate, compliant, and defensible.
Rated 5 stars
💎 20+ years of experience in medical coding, billing, and risk adjustment
💎 CPC & CRC certified with deep expertise in HCC coding and documentation integrity
💎 Advanced training in AI in healthcare and AI-assisted coding risk
💎 Focused on compliance, revenue integrity, and governing AI in regulated environments
★★★★★
Who We Serve
We work with healthcare organizations that need to understand their true risk exposure.
From risk adjustment coding to AI-assisted workflows, we audit, evaluate, and validate processes to identify unsupported diagnoses, overpayment risk, and compliance gaps, before they become audit findings or legal issues.
Our work is grounded in over 20 years of experience in medical coding, risk adjustment, and revenue cycle operations, with a focus on accuracy, accountability, and defensibility.
Strengthening Healthcare Organizations Through Compliance and Revenue Integrity
What We Do
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💎 Overpayment & FWA Risk Analysis
Targeted review to detect patterns of overcoding, unsupported HCC capture, and potential fraud, waste, and abuse exposure
💎 Risk Adjustment Compliance Audit
Comprehensive audit of coding and documentation to identify unsupported diagnoses, coding inconsistencies, and compliance gaps impacting revenue integrity.
💎 AI-Assisted Coding Risk Audit
Evaluation of AI-generated coding outputs to identify hallucinated or unsupported diagnoses and assess compliance risk within automated workflows.
Signature Services
Protecting healthcare revenue through compliance, audit, and AI governance.
💎 AI Governance & Compliance Framework
Development of structured oversight for AI use in coding and revenue cycle operations to ensure accuracy, accountability, and regulatory alignment.
💎 Audit Readiness & RADV Preparation
Preparation for internal audits, RADV reviews, and regulatory scrutiny by strengthening documentation, validation processes, and defensibility.
Deep analysis of coding accuracy and documentation using MEAT criteria to ensure all diagnoses are clinically supported and audit-ready.
💎 Revenue Integrity & Coding Validation Review
💎 Retrospective Chart Review & Risk Validation
Review prior-year encounters to identify unsupported diagnoses, validate HCC capture, and assess overpayment risk before external audit exposure
💎 Prospective Risk Adjustment Accuracy Review
Evaluate current-year documentation and coding practices to ensure diagnoses meet MEAT criteria and are supported for accurate, compliant submission.
Train coding and revenue cycle teams on identifying unsupported diagnoses, validating AI-generated outputs, and maintaining compliance in AI-assisted environments.
💎 Coding & AI Oversight Training for RCM Teams
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Get clarity on your coding, compliance, and revenue integrity.