Audit Services

Improve operational efficiency, decrease billing lag time, and so much more

Altegra Health’s client partnership approach is integral to our comprehensive facility and professional fee coding and audit services, which cover every specialty, inpatient and outpatient, and virtually any volume needs. Our expert reimbursement consulting, auditing, education, and coding staffing support services allow our clients nationally to evaluate and improve their financial performance, meet compliance obligations, increase cash flow, and streamline operations. Healthcare organizations including providers and payers must keep pace with ever-changing coding and reimbursement standards and methodologies. Altegra Health delivers expert consulting, auditing, education and coding support services to our partners to evaluate and improve their financial performance, meet regulatory requirements, increase cash flow, and streamline operations. Altegra Health offers unsurpassed accuracy and exceptional results, ensuring our partners realize improved operational efficiency, decreased billing lag time, decreased employee turnover, and reduced turnaround time for coding services.

Service Features

  • Coding Services – Strengthen your healthcare organization with a variety of coding capabilities, including outsourced coding services (Facility & Professional), temporary placement services, Health Information Management (HIM) consulting and coding management, and ICD-10 planning support, and training.
  • Professional Consulting Services – Develop compliance coding processes, charge ticket review and updates, as well as claim edit resolution and denial management.
  • Audit Services – Access a variety of needful third-party auditing services, including coding compliance, provider documentation, and reimbursement audits, as well as program development and audit assistance for Medicare Administrative Contractors (MAC), Recovery Audit Contractors (RAC), Medicaid Integrity Contractors (MIC), and Zone Program Integrity Contractors (ZPIC).
  • Staffing Services – Provides staffing services for contract, hourly, temp to perm, and direct hire positions.
  • Provider Education – Altegra can conduct onsite or remote education sessions with providers. The scope of these sessions will include a review of the audit results, example findings from the physicians’ own documentation and other items as requested, including specific specialty trends, modifier usage, and ICD-10-CM codes.
  • Clinical Documentation Improvement (CDI) – Provide interim CDI leadership, contract/temporary, program development and consulting & education to facilitate appropriate clinical documentation to support diagnosis capture and to ensure the level of service rendered to all patients is recorded.

Provider audit specialty areas include

Adult and Pediatric Surgery, Evaluation and Management Services including:

  • Bariatrics
  • Breast Reconstruction
  • Cardiothoracic
  • Cardiology/Electrophysiology
  • Cath Lab
  • Chiropractic
  • Colorectal
  • Critical Care
  • Dental/Oral Maxillofacial
  • Dermatology
  • Emergency Service
  • Endocrinology
  • ENT
  • Family Practice
  • Gastroenterology
  • General Surgery
  • Hematology
  • Hepatology
  • Hospitalists
  • Infectious Disease
  • Infusion
  • Internal Medicine
  • Interventional Cardiology
  • Laboratory
  • Maternal Fetal Medicine
  • Neurology
  • Nephrology
  • Nursing Home/Home Health
  • Pain Management
  • Palliative Care
  • Pediatrics
  • Pediatric Critical Care/NICU
  • Pulmonology
  • Observation Services
  • Obstetrics & Gynecology
  • Oncology
  • Ophthalmology
  • Optometry
  • Orthopedics/Orthopedic Spine
  • Pathology
  • Physical Therapy
  • Plastic & Reconstruction
  • Podiatry
  • Psychiatry/Psychology
  • Radiation Oncology
  • Radiology
  • Reproductive Oncology
  • Rheumatology
  • Transplant
  • Trauma
  • Urgent Care
  • Urology
  • Vascular
  • Wound Care

Facility PPS areas include

  • Inpatient
  • Outpatient (SDS, Diagnostic)
  • Emergency Department
  • Ambulatory Surgery Centers
  • Home Health/Hospice
  • Ambulance
  • DMA, PT/ST/OT services

Professional Fee Coding Specialty areas include

  • Cardiology
  • Critical Care
  • Emergency Service
  • Endocrinology
  • Family Practice
  • General Surgery
  • Hospitalists
  • Internal Medicine

  • Interventional Cardiology
  • Nephrology
  • Pulmonology
  • Obstetrics & Gynecology
  • Oncology
  • Ophthalmology
  • Plastic Surgery
  • Radiology

Partners We Serve

  • Ambulance Suppliers
  • Academic Medical Centers
  • Clinical Laboratories
  • Durable Medical Equipment Suppliers
  • Integrated Health Systems
  • Health Plans
  • Homecare and Hospice
  • Hospitalist Groups
  • Medical Groups
  • Skilled Nursing Facilities

For more information, contact:

Jason Abou-Samra
Regional Director, Sales & Client Services, Provider Solutions

877.271.2762 ext. 2518

Mark Sampson
Strategic Accounts Manager, Sales & Client Services, Provider Solutions
877.271.2762 ext. 2334

Jon Merz
Director, Staffing Operations, Provider Solutions
877.271.2762 ext. 2517