Healthcare Audit Service
Location:
Kentucky, United States
Posted on:
Deadline:
Summary:
Kentucky government requires comprehensive healthcare coding audit and consulting services, including inpatient and outpatient coding reviews for compliance and quality improvements.
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The government authority in Kentucky is seeking a vendor to provide healthcare audit services, including comprehensive consulting for its system and affiliates. The mandate covers coding audits to assess accuracy and to identify opportunities for improved quality and compliance.
The scope of work encompasses inpatient coding reviews and verification of MS–DRG or APR–DRG groupings as needed, ICD–10–CM and ICD–10–PCS codes, POA indicators, and discharge status. Additional services may include audits of medical necessity and outpatient coding.
Selected contractors will be expected to deliver thorough assessments and actionable recommendations to strengthen coding practices and compliance within the healthcare system.
Best-fit vendors:
• Healthcare consulting firm with expertise in coding audits
• Experience with MS–DRG, APR–DRG, ICD–10–CM, and ICD–10–PCS codes
• Proven track record in medical necessity and outpatient coding assessment
• Strong compliance and quality assurance capabilities
• Prior work with government healthcare entities
