Enhanced quality and compliant coding positively impacting reimbursements and denials with IKS Health coding audit

About the academic medical center

A large academic medical center in the Southeast with over 1800 physicians providing leading-edge patient care offering more than one hundred medical specialties, including a leading eye hospital, NCI designated cancer center, cardiac surgery program and over 40 outpatient sites.

The need for stronger coding compliance

The medical center wanted a partner to strengthen coding compliance across a large and complex physician enterprise. They were looking for:

A structured audit, governance, and education program

IKS Health implemented its coding audit solution to pinpoint focused areas for audit and establish a baseline level of accuracy across every patient type and specialty. To keep the partnership on track, the team set up a governance process with a defined cadence, starting weekly and settling into a bi-weekly rhythm as the work matured.

A pre-bill audit process with a set turnaround time raised the quality and accuracy of coding before claims were ever submitted. IKS Health built client-specific reporting tied to defined business outcome metrics, then tracked and trended results at the individual coder level to drive steady quality improvement. Monthly coder education followed directly from audit findings and trends, with additional education delivered to coding leadership across management and supervisors.

The results after standardizing coding audits

The partnership improved accuracy and quality while giving the medical center a governance and remediation model it could rely on.

10%

Increase in coding accuracy across patient types

8-9%

Improvement in coding quality, easing the denial rate and lifting reimbursement