At AbacusOne we have curated a best-in-class team of certified compliance professionals with over 50 years of combined HIPAA, revenue cycle, coding, and general compliance experience. Our seasoned professionals provide wide-ranging expertise working for and with hospital systems, physician practices, and revenue cycle organizations.

Our compliance team works closely with leaders in all functional areas of the company and our clients to develop, implement, and continuously enhance our compliance program. We integrate compliance knowledge and accountability into the day-to-day role of every associate. Compliance is part of our DNA!

We welcome the opportunity to serve you and help you grow your business.

Auditing and Compliance Assessments

A core element of our Compliance Program includes the use of audits to identify and prioritize risks, monitor compliance, and assist in the reduction of identified problem areas.

• According to the OIG HHS, 42% of Medicare claims for E/M services were coded incorrectly in recent years. Failure to validate your physician’s coding and documentation puts your organization at risk.
• AbacusOne provides a comprehensive assessment of documentation, coding, and billing. We assess existing coding and documentation processes, and fee schedules that may affect your organization’s revenue or cause compliance risks. Our goal is to identify improvement opportunities and help you achieve optimal cash flow and efficiency.

Our Pre-Audit Assessment will engage key stakeholders to define scope and deliverables that incorporate your unique standards and requirements. AbacusOne conducts audits using your local CMS carrier guidelines for applicable services. Where CMS guidelines are not pertinent or do not apply, we audit using industry standards from ICD-10-CM, CPT^®4, HCPCS.

Our deliverables include an executive summary, a detailed financial opportunity analysis, KPI comparisons to best practice with actionable recommendations. Based on the audit findings, you will receive documentation tips and recommendations for improvement. Additionally, we can provide numerous education and training services, tailored to your specific needs to ensure that your organization operates at the highest level both now and in the future.