Clean claims start with immaculate clinical coding. V1RCM provides specialty-specific certified coders backed by real-time NCCI edit validation and guaranteed sub-24-hour turnaround.
Select your clinical discipline to view our tailored workflows, compliance standards, and revenue impact:
Capture complete patient illness severity and disease burden for Medicare Advantage, ACA, and ACO value-based contracts.
Bilateral coding intelligence: rapid claim creation for providers and high-rigor validation and audit defense for payers.
Non-intrusive physician query workflows that reduce Discharged Not Final Billed (DNFB) and elevate Case Mix Index (CMI).
High-acuity emergency department encounter coding and AMA 2023/2024 MDM scoring for facility and professional fees.
High-precision Inpatient DRG (MS-DRG/APR-DRG) assignment, ICD-10-PCS coding, and aggressive clinical validation appeals for CC/MCC downgrades.
Multi-specialty operative note mastery in orthopedics, cardiology, neurosurgery, and general surgery with unbundling protection.
Precision surgical pathology levels, biopsy evaluations, immunohistochemistry, and flow cytometry CPT code capture.
MRI, CT, Ultrasound, and interventional vascular coding with flawless Technical (-TC) and Professional (-26) split billing.
PDGM compliance, OASIS clinical reviews, HIPPS code generation, and proactive Low Utilization Payment (LUPA) mitigation.
OIG and CMS-aligned baseline chart audits. CPMA-credentialed reviews to eliminate over-coding liability and uncaptured specialty revenue.
Find out if under-coding or modifier missteps are siphoning revenue from your bottom line. We provide a zero-cost 25–50 chart baseline audit with full variance analysis.