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Medical Coding & Billing Due Diligence Before Medical Practice Merger or Acquisition

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Why Are Medical Coding & Billing Due Diligence Important?

There are numerous reasons why you would want to engage in thorough medical coding and billing due diligence before a practice merger or acquisition. However, the most important is to ensure compliant and accurate documentation, as well as timely and accurate coding and billing.

By checking into this history, you can determine a lot about the financial well-being of a practice, including how it affects the overall value. Additionally, non-compliant billing and coding can increase the liability risk for a medical practice. If you are taking control of that practice, that liability carried onto you. Thus, it is important to know what you are dealing with from the very beginning by doing a thorough job of due diligence.

Coding Due Diligence Benefits

It’s important to realize that the benefits of coding due diligence go far beyond just checking for liability issues. For example, you can enjoy greater visibility in coding patterns and have a more complete basis for your purchasing decision.

Working with Symbion Coding Inc to obtain this type of report also ensures diagnoses and procedures described in the patient’s health records are appropriately coded. In turn, this allows you to identify whether the risk lies with the physician, coders, or some combination thereof.

Working with Symbion for Coding Due Diligence

At Symbion, we are here to make the due diligence portion of your acquisition or merger easy. Our experts can help detect a variety of elements including:

  • Whether E/M documentation meets all appropriate guidelines or not
  • Any possible missed opportunities for HCC codes for Medicare Risk Adjustment
  • Determining if diagnosis and procedure coding guidelines are followed
  • If file documentation routinely supports medical necessity
  • Whether medical records are being copied and/or pasted versus individually prepared for each unique patient

And that is just the start of what we’re usually able to uncover. By having these details, you can make a better determination and wiser decisions during your business transaction.

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Receive a Complete and Detailed Report from Symbion

So, what does Symbion provide with our medical coding and billing due diligence service? First, we offer a quick turnaround time to help you get the information you need when it is most important. Second, the report we offer is fully confidential and we also routinely work with attorneys to ensure attorney-client privilege. In the end, you will receive a report that not only shows errors, but also identifies possible root causes, opportunities for documentation improvement, analysis of results with potential impact, and recommendations to address the identified issues.


Jean Delva
Founder & CEO of Symbion Coding, Inc.
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