Coding Audit Services
Coding accuracy, clearly delivered.
Sagility helps health plans validate coding accuracy and compliance through targeted post-pay coding audits. Our certified coders apply payer rules, coding standards, and analytics-driven workflows to identify discrepancies and reduce financial and regulatory risk.
Overview
As part of Sagility’s Payment Integrity Suite, our Coding Audit Services focus on identifying coding errors and compliance risk in paid claims. These audits can be performed with or without medical records, depending on the audit scope and claim type.
Coding Review
- Review International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Diagnosis-Related Group (DRG), and modifier accuracy
- Identify coding discrepancies, upcoding, and compliance risk
- Apply payer rules and national coding standards
- Support accurate payments and defensible audit outcomes
- Utilize claims data and coding logic; documentation requirements vary by audit type
Decades of Partnership, Performance, and Progress.
Clients stay with Sagility for a reason: deep-domain expertise, measurable outcomes, and a true partnership approach. Purpose-built for healthcare and trusted by the nation’s top health plans and providers, we bring decades of experience and a proven ability to simplify operations and deliver lasting impact.
Straight from the Source
We’re more than a vendor, we’re a partner. Here’s what our clients have to say:
Sagility brings deep operational and process expertise and pivots quickly in response to emerging needs. The team is highly receptive to feedback and takes action with minimal direction.
Associate Director, Payment Integrity,
National Health Plan
Sagility is a team I can count on to give their best effort and work diligently to complete any assigned task. They make excellent use of available resources to deliver work efficiently, effectively, and accurately.
Operations Specialist, Implementation, and Strategic Projects,
Regional Health Plan
Their strength lies in their flexibility and adaptability — stepping in to support any situation and responding quickly to issues. The Sagility team in Bangalore is a tremendous asset to the organization. The office environment and team culture make it feel as though you are walking into a client facility when on site.
Vice President, Operations,
Healthcare Financial Services Company
Case Studies
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