When a dispute turns on whether a service was coded correctly, whether documentation supported a claim, or whether a billing practice fell outside professional standards, someone has to explain that to people who do not work in medical billing.

We provide that analysis. Chart by chart, code by code, with findings written so a judge, an arbitrator, or opposing counsel can follow the reasoning.

• Payer disputes involving alleged overpayment or improper billing
• Coding accuracy questions in professional liability matters
• Practice dissolution and partnership disputes where billing conduct is contested
• Acquisition disputes involving representations about revenue or billing integrity
• Employment matters where coding or billing performance is at issue
• Fraud and abuse allegations requiring independent coding analysis

We also do a fair amount of consulting work that never reaches testimony, which is often the better outcome for everyone involved.

We look at a sample of the material and tell you candidly whether the record supports the position you are taking. If it does not, you want to know that early.

Systematic review of the charts, claims, and payer correspondence at issue, documented so each conclusion traces back to a specific record.

Findings, methodology, and the professional standards applied, prepared to withstand examination.

Available where the matter requires it.

Cyndi Walker holds the Certified Medical Coder and Certified Healthcare Business Consultant designations, with more than forty years of professional experience in medical billing and coding. She presents on coding, payer appeals, and payer regulation for the National Society of Certified Healthcare Business Consultants.

Medicus Billing and Consulting holds corporate accreditation from HBMA and NSCHBC.

• Chart Review and Clinical Audit Services
• Healthcare Compliance
• Coding Education and Training

Contact us to talk through scope, timeline, and availability.