We deliver end-to-end medical coding services designed to optimize outcomes for both Payers and Providers. Our specialized expertise in risk adjustment coding empowers healthcare providers to accurately capture patient acuity, which directly influences their performance in value-based care models.
Through our Provider Risk Adjustment Coding Program, we play a strategic role in supporting provider incentive plans. By identifying undocumented chronic conditions and validating diagnosis codes, we help providers ensure coding compliance, reduce audit risks, and most importantly, unlock additional reimbursement opportunities tied to accurate risk scores.
Benefits to Providers:
Whether you’re on the payer side seeking accurate and timely coding, or a provider aiming to boost revenue through smarter documentation, our services are tailored to meet your goals with precision and integrity.
Provider coding focuses on claim creation, while payer-side coding emphasizes validation, auditing, and reimbursement accuracy.
Yes. We tailor our approach to the needs of each side, ensuring clarity, compliance, and maximized financial outcomes.
Absolutely. We offer flexible staffing models based on specialty, volume, and turnaround time.
Yes, our coders can address CCI edits, NCCI conflicts, and missing documentation that delay claims or trigger denials.
Through continuous QA, documentation audits, and adherence to payer-specific guidelines and LCD/NCDs.
Yes, we generate regular insights on denial patterns and recommend remediation strategies.
Have questions about our services or how we work? We’ve compiled answers to the most common queries to help you better understand what Spy Health offers and how we can support your healthcare organization. Whether you’re new to medical coding and RCM or looking to switch providers, our FAQs are here to guide you.
+1(978) 502-4707
sales@spyhealthrcm.com
Accurate. Compliant. Certified.
We provide precise medical coding solutions by certified professionals to ensure clean claim submission and faster reimbursements.
We offer risk adjustment coding which required highly skilled coding professionals to work together to capture the health status of their patient
We specialize in designing and implementing Clinical Documentation Improvement (CDI) programs tailored to the needs of hospitals, physician groups, and healthcare
We providing complete full service, end-to-end coding and billing for ED visits. In addition to offering a complete ED revenue cycle management solution, we also
We offer targeted and effective HEDIS coding services that support healthcare plans in achieving excellence in quality reporting. Developed by the (NCQA)
We recognize that every denied claim tells a different story—and resolving it demands more than just routine follow-up. Our approach to (A/R) and Denial Management
We providing highly trained & efficient team for pathology coding services, By utilising Current Procedural Terminology (CPT) codes to describe medical procedures,
We provides expert radiology coding services for our clients with fully knowledge in relevant CPT codes for radiology procedures, such as X-rays
We coding service affords our clients access to specialty-driven coding experts. A designated project manager will serve as your primary point of contact
Streamline Your Billing. Maximize Revenue.
From patient registration to final payment, our end-to-end RCM services help healthcare providers boost cash flow and reduce denials.
Eligibility and Insurance Verification services stand as linchpins in ensuring the
Effective Patient Scheduling is not just about managing Patient Appointments. Effective capture
The primary reason for claim denials is because a patient is not eligible for services billed to the insurer by the provider.
In the realm of effective medical billing, administrators often highlight coding and clinical documentation
Healthcare organizations often grapple with administrative stress caused by outstanding claims and
As the foundation of any healthcare insurance claims, patient’s demographic entry is very important
The process of claims submission involves parsing of claims information from the RCM
Denial management services serve as an indispensable pillar in upholding the
We provide comprehensive patient statement services. We generate patient
Partner with Spy Health for expert medical coding and revenue cycle management solutions. Our team is here to support your growth with precision and reliability.
Spy Health’s team of over 800 AAPC & AHIMA-certified medical coders precisely assign accurate codes to ensure regulatory compliance and facilitate timely, appropriate reimbursement.
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