PDN programs face complex authorizations, scheduling, and documentation standards tied to medical necessity. We tune workflows and contracts, so clean care gets paid on time.

• Authorization/eligibility alignment and visit validation
• Documentation sufficiency and plan-of-care compliance
• Billing accuracy (time, units, supervision) and edit tuning
• Contract review and under/over-payment detection

Therapy groups need precision on progress documentation, frequency/duration limits, and modifier use. We cut avoidable denials and improve first-pass yield.

• Documentation standards (goals, progress, re-evals)
• Modifiers and coding accuracy (e.g., 59/76, time-based rules)
• Pre- and post-pay controls; appeal kits and training
• Contract benchmarking and payer mix strategy

High-scrutiny services demand airtight documentation, clear medical necessity, and payer-specific policies. We help you defend appropriate care and prevent FWA risk.

• Admission/continued-stay criteria alignment
• Documentation/coding audits and clinical correlation
• Prepayment review support and audit response
• Network integrity checks and contract term review

Speed can’t come at the expense of accuracy. We optimize coding, place-of-service, and payor edits so urgent care claims pay quickly and cleanly.

• E/M leveling, procedures, and modifier use
• Eligibility/benefit design linkage to reduce front-end denials
• Posting/reconciliation discipline; underpayment detection
• Contract terms (timely filing, audit windows, escalators)

Primary care is the revenue backbone for many systems—small leaks compound quickly. We standardize workflows, documentation, and payor alignment to keep cash predictable.

• Preventive care coding, chronic care management, and risk-adjustment accuracy
• Referral/auth pathways and pre-visit checks
• Denial trending, appeal kits, and staff training
• Contract benchmarking and proof-of-payment audits