Medical Coding Services for Payers

Full-service coding support for payers and health plans — from claims coding and HCC coding to audits, denials, and compliance. Optimize claims accuracy, reduce denials, and improve payment integrity.

What We Offer

Comprehensive Coding Services for Health Plans

Valiant Lifecare delivers turnkey medical coding services for payers, including HCC/risk coding, DRG validation, E/M assignment, claim-clean coding, and audit-ready workflows to ensure coding accuracy and compliance.

Services Offered

Our Medical Coding Services

We support the entire coding lifecycle, from initial claim coding, risk adjustment, audits, to denial management, tailored for health plans and payer operations.

Clean Claims Coding

CPT, ICD-10, HCPCS coding with payer-edit compliance and claim-clean coding to minimize downstream denials.

HCC & Risk Adjustment Coding

Chart-based HCC coding, RAF optimization, and risk-adjustment audits for Medicare Advantage and risk contracts.

DRG & Inpatient Coding Validation

Accurate DRG assignment and validation, supporting inpatient claims and audits.

Audit & Quality Reviews

Retrospective and prospective coding audits, NCCI compliance checks, and medical necessity reviews.

Denial Analysis & Appeals

Code-level denial root-cause analysis, appeals support, and re-submission workflows to recover denied claims.

High Volume & Backlog Clearance

Flexible outsourcing models — full or partial — to clear backlog or support overflow coding needs.

Compliance & Regulatory Coding

Auditable coding aligned with payer regulations, coverage rules, and compliance requirements.

Custom Configuration & Workflow Integration

Tailored coding workflows, rule-sets, and integration with payer adjudication systems.

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Our Process

How Our Coding Workflow Operates

Intake

Receive claims data, charts, provider records, and documentation securely.

Pre-Coding Validation

Eligibility, benefit rules, and documentation completeness check.

Coding Assignment

CPT, ICD-10, HCPCS, DRG, HCC & risk codes applied with payer logic.

Quality Assurance Review

Secondary review, compliance checks, and audit trails.

Denial Prevention & Readiness

Code-level validation to prevent denials and ensure documentation supports coding.

Delivery & Reporting

Clean claim submission, coding logs, and analytics-ready outputs.

Speak With an Expert

Improve Your Operational Outcomes. Connect with us today for a no-charge in-depth Consultation before we begin optimizing your operations.

Email us:

sales@vlms-global.com

Call us:

1-800-782-1768

Visit us:

1015 15th Street NW #600, Washington DC, 20005, USA.

Schedule a Free Consultation

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