Compliance & audit
The audit letter isn't an if. It's a when. Be ready.
HIPAA compliance, chart review, coding audits, audit defense. Built for high-scrutiny specialties — podiatry, dermatology, cardiology, plastic surgery — where payer scrutiny is a feature of the business, not a surprise.
Every practice owner has the same response when the RAC letter arrives: a wave of anxiety, followed by a scramble. The scramble is worse than the audit itself. Charts pulled by a stressed biller, documentation gaps discovered in real-time, late submissions to the payer.
The practices that do well in audits don't scramble. They pull the defense file they've been maintaining all year, hand it to a compliance lead who's been sampling the same codes monthly, and respond inside the deadline with a clean package.
The Medicare look-back period is six years. The commercial payer look-back is whatever the contract says. The best time to start acting audit-ready is before you have to.
Concretely, this is the work.
HIPAA compliance program — risk analysis, safeguards, workforce training, breach notification readiness.
Monthly chart-review sampling calibrated to your specialty's high-risk code categories.
CPT and modifier coding audits — internal before external.
Defense-file maintenance for every high-audit-risk code category (DME, Mohs, high-level E&M, etc.).
Audit response management — RAC, OIG, commercial payer — we handle the letter start-to-finish.
Compliance reporting that flags exposure before it becomes a letter.
Medical necessity documentation templates for at-risk procedures.
Specialty-calibrated sampling
Podiatry's audit profile is different from dermatology's. We sample the right codes for your specialty, not a generic checklist.
Prevention, not response
By the time the letter arrives, your defense file is already built. Response is a retrieval exercise, not a scramble.
Coordinated with billing
When compliance and billing are separate vendors, things fall through the seams. We run both under one roof.
No cliff. No rip-and-replace.
Days 1–30 · Risk assessment
Current HIPAA posture reviewed. Top 10 highest-audit-risk CPT codes identified for your specialty. Documentation sampling begins.
Days 31–60 · Defense files
Defense files built for top-risk codes. HIPAA gaps closed. Workforce training delivered. Templates installed.
Ongoing · Monthly discipline
Rolling chart review. Monthly compliance report. Immediate escalation for any RAC/OIG/payer letter.
Real numbers, measured against your own baseline.
- Medicare audit look-back — we cover it
- 6 years
- Chart review sampling
- Monthly
- Audit letter escalation
- Same-day
- Defense files before the letter
- Ready
Every practice we work with — but especially podiatry, dermatology, cardiology, and plastic surgery where audit exposure is higher. For groups already under a RAC or OIG audit, we can come in mid-process.
Free audit
Curious where your practice is leaking money?
We'll audit your current workflow for free and show you exactly where to act — usually in under a week. No contract. You keep whatever we find.