Code Healthcare Solutions
(239) 544-4102
customerservice@code-hcc.com
About Us
We provide specialized consulting and education to healthcare organizations navigating the complexities of medical coding, billing, claims management, value-based care, and regulatory requirements.
Our focus is on helping practices and healthcare teams better understand their processes, identify areas for improvement, and implement practical strategies that support accurate, efficient, and compliant operations.
With experience spanning medical coding, billing, clinical documentation, claims resolution, risk adjustment, quality programs, and revenue cycle operations, we bring a real-world perspective to the challenges healthcare organizations face every day.
Rather than taking over your coding or billing functions, we work collaboratively with your team—providing guidance, education, workflow support, and industry insight that can help strengthen internal processes and build staff confidence.
Consulting services can be tailored to address specific operational challenges, improve coding and billing best practices, support value-based care initiatives, or provide workforce education.
Available virtually and on-site, our services are designed to provide organizations with knowledgeable, practical support while allowing your team to maintain ownership and oversight of its day-to-day operations.
Expert guidance.
Practical solutions.
Stronger healthcare operations.
Our Team
Expertise You Can Trust.
We believe healthcare organizations deserve guidance from professionals who understand the complexities and responsibilities of medical coding, billing, reimbursement, and compliance.
That’s why our professional consulting and education services are delivered exclusively by individuals who hold applicable certifications through AAPC or AHIMA, two of the nation’s leading credentialing organizations for health information and medical coding professionals.
This commitment helps ensure our clients receive knowledgeable, professional guidance grounded in recognized industry standards and current healthcare practices.
Certified expertise.
Professional guidance.
A commitment to quality.
Our Services
Practical, experienced support to help healthcare organizations strengthen billing operations, improve coding accuracy, address reimbursement challenges, and navigate evolving compliance and quality requirements.
Coding & Billing Best Practices
Accurate coding and billing are essential to both reimbursement and compliance. We evaluate current workflows and provide practical guidance designed to help your team improve accuracy, consistency, and efficiency.
Consulting may include:
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Coding and billing workflow assessments
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Documentation and coding alignment
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CPT, HCPCS, ICD-10-CM, and modifier review
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Medicare billing considerations
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Evaluation of internal billing processes
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Identification of compliance and reimbursement risks
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Staff education and workflow recommendations
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Development or refinement of coding and billing procedures
Value-Based Care, Risk Adjustment & Quality Programs
Value-based reimbursement requires organizations to look beyond traditional claims processing. We help practices better understand the connection between clinical documentation, diagnosis coding, quality reporting, and the data ultimately reflected in payer and health plan reporting.
Services may include:
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Risk adjustment coding and documentation review
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HCC documentation and coding education
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Suspected documentation and coding gap analysis
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Quality measure and CPT II reporting review
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Claims and clinical documentation comparison
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Identification of potential reporting opportunities
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Provider and staff education
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Workflow recommendations for value-based care initiatives
Our goal is to help organizations develop processes that support accurate, compliant, and complete reporting—not simply maximize reported risk or reimbursement.
Clinical Documentation Integrity (CDI)
Clear, complete clinical documentation supports accurate coding, appropriate reimbursement, quality reporting, and effective communication across the healthcare team.
Our Clinical Documentation Integrity consulting services help organizations strengthen documentation practices through education, workflow guidance, and practical support. We work collaboratively with providers and staff to identify documentation challenges and improve understanding of the information needed to accurately represent the patient’s clinical picture.
Services may include:
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Provider and staff documentation education
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Documentation best-practice guidance
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Risk adjustment and HCC documentation education
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Support for value-based care documentation requirements
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Guidance on documenting medical necessity and clinical specificity
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Workflow recommendations to improve documentation consistency
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Education on the relationship between documentation, coding, quality reporting, and reimbursement
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Development of documentation-focused training materials and resources
Our goal is to help healthcare organizations build stronger documentation practices that support accuracy, compliance, and better overall revenue cycle performance.
Claims Resolution & Revenue Cycle Support
Unresolved, denied, or underpaid claims can quickly impact cash flow and consume valuable staff resources. We help identify the issues contributing to payment delays and work with your team to develop practical solutions for improving claims outcomes.
Services may include:
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Denied and rejected claim review
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Unpaid and underpaid claim analysis
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Claims workflow troubleshooting
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Coding and billing issue identification
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Payer-related reimbursement concerns
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Accounts receivable and follow-up process review
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Recommendations to reduce recurring claim issues
Need help identifying where to start?
Schedule a consultation to discuss your organization's current challenges and determine which services may be the best fit.
What Our Client's Say
"...contributions have had a measurable impact on the accuracy of our reporting, the timeliness of our billing cycles, and the overall strength of our compliance operations"
"...demonstrates a deep understanding of both the technical and clinical aspects of medical coding. Beyond technical skill, CHS stands out for trustworthiness, reliability, and efficiency"
"...in-depth understanding of clinical documentation, coding compliance, and operational workflows that have been invaluable to our success"
"...responsiveness, excellent communication skills, and collaborative nature"
"...approaches work with integrity and consistency, often completing projects ahead of schedule without compromising quality"
"...demonstrated outstanding knowledge of Medicare Risk Adjustment (MRA), Hierarchical Condition Category (HCC), HEDIS, and pay for quality processes within today's healthcare world"
"CHS improved our reputation with our Medicare Advantage and other pay for quality payors."
"Many people have the knowledge but are unable to communicate in an effective manner with healthcare practitioners. Our providers are now "all in" with our pay for quality program."
"CHS developed our coding department single handedly into a highly competent department."
"CHS benefited our company financially far more than the cost for their services."
