The Challenge
A multi-specialty clinic was struggling with:
- High claim denials due to coding errors and incomplete documentation
- Lack of certified coders familiar with specialty-specific requirements
- Manual processes slowing down coding turnaround time
- Revenue leakage from under-coded or incorrectly coded procedures
Our Approach
Aivra Health deployed its certified coding team and technology-driven solutions to bring accuracy and speed into the process:
- Specialty-Certified Coders: Ensured accurate CPT/ICD coding across multiple specialties.
- Automated Coding Audits: Identified errors before claim submission, reducing rejections.
- Compliance-First Approach: Aligned all codes with payer guidelines and HIPAA standards.
- Continuous Training: Provided coding updates to match evolving payer and CMS regulations.
The Results
- Claim accuracy improved to 98% within 90 days
- Denial rate reduced by 60% through proactive error prevention
- First-pass claim acceptance increased by 35%
- Recovered $300,000+ in under-coded services annually
- Providers gained confidence knowing billing was compliant and optimized
