Independent and employed groups balancing audit risk against clinic speed.
The engagement
Cleaner E/M coding; MIPS performance support; defended audits; and documentation workflows that fit the clinical day.
Week 1 — intake: coding and MIPS posture, and exposure. Weeks 2–4 — E/M and documentation review. Ongoing — in-workflow coding checks and payer-audit response.
Regulatory context
Office-based billing turns on rules that changed and reviewers that didn’t relent. E/M now scores on medical decision-making or time (the 2021 office-visit and 2023 facility revisions), shifting what the note must show. MIPS holds a 75-point performance threshold with penalties to −9% under the CY2026 fee schedule. And CERT data keeps pinning improper payments to coding — 99214 alone at $459 million, with incorrect coding the leading driver of E/M errors.
From revenue cycle through audit defense — each shaped to your operation.
The cross-cutting capabilities we bring to physician groups, framed for clinic speed:
Each service shaped to the specific pressure observed.
Three reasons physician groups choose us:
We work alongside your team, not around them. Credentialing coordinators, billing leads, and physician owners all stay involved. We bring methodology; you keep operational ownership.
Credentialing built for the revenue cycle. Provider start date is also billing start date. Tracked to payer, tracked to dollar.
Audit findings we can actually defend. When commercial or OIG scrutiny lands, our documentation holds — because we built it to hold from day one.
What’s the biggest coding exposure?
E/M level selection. 99214 alone drove $459M in overpayments, and incorrect coding is the leading driver of E/M errors.
How does MIPS affect us?
The threshold is 75 points; falling short risks up to a −9% payment adjustment. Documentation drives both quality scoring and payment.
Can you reduce audits without slowing us down?
Yes — we build documentation and coding checks into the workflow, not after hours.
Are you a law firm?
No — we’re expert consultants and licensed investigators who fix the documentation between patients, not after subpoenas. When a matter does turn legal, we work under your counsel and can testify. Nothing here is legal advice.
Tell us what you are up against. Scoping memo in week one, before any meaningful commitment.