Cotiviti’s AAPC- or AHIMA-certified clinician coders have an in-depth understanding of risk adjustment coding standards and specific Centers for Medicare and Medicaid Services (CMS) rules and guidelines. Our coders review digitized medical records, considering the appropriate diagnosis condition hierarchies and interactions. They provide thorough code capture from a member’s medical chart to ensure that all appropriate diagnoses are identified and supported in preparation for submission to CMS. On average, 96% of Medicare charts suspected, retrieved, and coded by the Cotiviti Risk Adjustment team contained undocumented chronic conditions.

• Achieve >95% coding accuracy
• Improve coding project turnaround times
• Facilitate provider education on appropriate medical chart coding
• Improve submissions compliance
• Reduce risk adjustment data validation (RADV) audit risk