Retrospective Chart Review

Retrospective review occurs after care is provided and payments are made for the calendar year. Often there are diagnoses supported by chart documentation which were not reported to CMS as well as diagnoses that should not have been reported because they do not meet documentation guidelines.

Supported by targeted proprietary analytics, Beacon Review’s team of Certified Professional Coders/Certified Risk Coders will identify supported HCC diagnoses that should be submitted as well as unsupported diagnoses that should be deleted. Strict adherence to established guidelines for acceptable documentation ensure all reported diagnoses are adequately supported and our clients’ risk scores are as accurate as possible. Our coders receive regular training on all new updates to ICD10 coding regulations and CMS policy changes.

We are able to effectively work in conjunction with client staff, either remotely or on site, to provide a comprehensive retrospective review program for your members.