Client Profile
- Type: Orthopedic Group
- Size: 8 providers
- Location: California
About The Client
This orthopedic group faced frequent audits and denials due to inconsistent coding and documentation. Manual review processes were slow, and the team lacked tools to track coding performance or identify provider-level errors.
Challenges
- Coding accuracy at 90%, below industry benchmarks
- Audinalties and re-submissiot pens costing thousands monthly
- Documentation gaps led to compliance risks
- No system for tracking coding trends or provider errors
ImpactRCM’s Approach
- AI-Powered Coding Validation for CPT/ICD accuracy
- Payer-Specific Compliance Rules to reduce audit exposure
- Audit & Feedback Dashboards to monitor coding by provider
- Education Alerts based on payer rule changes
Results After 2 Months
| Performance Indicator | Before ImpactRCM | After ImpactRCM |
|---|---|---|
| Coding Accuracy | 90% | 98.6% |
| Audit Risk | High | ↓70% |
| Denial Rate | High | ↓32% |
| Compliance Confidence | Low | Significantly improved |
Conclusion
ImpactRCM enabled this orthopedic group to achieve audit readiness and coding precision through AI-driven compliance intelligence. The platform helped reduce financial risk and improve documentation standards across providers.
