Forensic Billing
Services
We review billing, coding, claims, and documentation to identify errors, compliance issues, and missed revenue helping hospitals, physicians, and healthcare organizations protect their revenue cycle.
Forensic Billing Services for Healthcare Organizations
Forensic billing is a structured review of a healthcare organization's billing records, medical coding , claims submissions, and related documentation. The goal is to surface errors, inconsistencies, compliance concerns, denial patterns, and missed reimbursement opportunities that might otherwise go undetected.
Chase Clinical Documentation brings more than 40 years of healthcare and clinical documentation experience to this work. Our certified coders and auditors conduct detailed billing and coding reviews whether you need a focused audit, ongoing compliance support, or help recovering denied claims.
Clients work with us on a per-month or per-hour basis. There are no long-term contracts and no risk during the 5-day training period, which we provide at no charge.
"Forensic billing is not just about finding errors it's about understanding why they occur and building a clearer picture of your revenue cycle."
What a Forensic Billing Review Covers
A Chase forensic billing review examines the full billing and coding chain — from front-end submission to back-end error correction.
We review submitted claims for accuracy, completeness, and compliance — catching clerical errors and billing inconsistencies before or after submission.
Our certified coders audit ICD-10 diagnosis and procedure codes — identifying miscodes, upcoding, undercoding, and sequencing issues that affect payment.
We conduct front-end NCCI compliance reviews and resolve National Correct Coding Initiative edit conflicts that result in claim denials or reduced reimbursement.
We manage denial workflows — reviewing denial patterns, preparing appeals, and correcting the underlying coding or documentation issues that drive repeat denials.
Accurate coding depends on complete documentation. We review clinical records to ensure diagnoses, procedures, and supporting notes are captured correctly.
Where errors are found, we correct and recode claims — handling both coding errors and clerical mistakes that affect reimbursement or compliance standing.
How Forensic Billing Helps Improve the Revenue Cycle
A structured billing and coding review creates visibility across your revenue cycle — surfacing patterns that manual workflows often miss.
Front-end NCCI compliance reviews and pre-submission checks reduce the volume of errors that reach payers in the first place — lowering denial rates at the source.
NCCI edits remain a frequent source of claim rejections. Chase identifies which edit combinations are triggering denials and corrects submissions accordingly.
We manage the appeals process — re-coding, correcting documentation errors, and resubmitting claims to support healthcare revenue recovery where claims have been incorrectly denied.
Whether the issue is incorrect ICD-10 sequencing, a modifier error, or a data entry mistake, back-end correction brings claims into compliance and restores accurate reimbursement.
Consistent medical billing analysis creates a feedback loop — identifying systemic issues so internal teams can improve processes rather than repeating the same errors.
A healthcare revenue cycle audit gives leadership a clearer picture of where billing performance stands — and where the most meaningful improvements can be made.
Why Healthcare Organizations Outsource Forensic Billing
Internal coding teams carry significant workload. High-volume denial queues , NCCI conflicts, and complex coding reviews can pull experienced staff away from their primary responsibilities. Outsourcing forensic billing work allows your internal team to focus on complex accounts while Chase handles appropriate high-volume review work with certified, specialized expertise.
Clients also benefit from flexible engagement. Chase works on a per-month or per-hour basis — no long-term contracts, and no charge during the initial 5-day training period.
Specialized Coding Expertise
Dedicated staff with AHIMA CCS, CCS-P, and CPC credentials focused entirely on audit and forensic billing work.
High-Volume Capacity
Handle large denial queues and review backlogs without increasing internal headcount or diverting existing resources.
No Long-Term Commitment
Flexible per-month or per-hour arrangements with a no-charge training period — engage as needed without contractual risk.
Experienced Clinical Staff
Staff with bachelor's degrees and relevant clinical healthcare backgrounds — not simply data processors.
Experienced Medical Coding and Billing Professionals
Chase Clinical Documentation has served U.S. healthcare organizations since 1980 more than 40 years of experience in clinical documentation, medical coding, and billing services.
Our auditing and coding staff hold bachelor's degrees and carry recognized industry certifications. We serve hospitals, physician practices, home health agencies, and hospice organizations across 500+ locations nationwide.
Frequently Asked Questions
Forensic billing services involve a detailed, structured review of a healthcare organization's billing records, coding, claims submissions, and related documentation. The purpose is to identify errors, compliance issues, denial patterns, and missed reimbursement that routine billing workflows may not catch. Chase provides forensic billing analysis for hospitals, physicians, and other healthcare organizations across the U.S.
Chase reviews billing and claims accuracy, ICD-10 medical coding, NCCI edit compliance, denials and appeals, clinical documentation, and back-end coding or clerical errors. Reviews can be focused on a specific issue or conducted as a broader revenue cycle audit, depending on client needs.
Forensic billing helps with denials in two ways: identifying the root causes of recurring denial patterns so they can be addressed upstream, and managing the appeals process for claims that have already been denied. Chase reviews denial trends, corrects coding and documentation issues, and resubmits claims where appropriate to support healthcare revenue recovery.
Hospitals, physician practices, medical groups, home health organizations, and hospice providers can all benefit from forensic billing services. Organizations experiencing high denial volumes, NCCI edit issues, revenue cycle concerns, or billing compliance questions are especially well-suited for this type of review.
Chase offers per-month and per-hour pricing depending on the client's needs. There are no long-term contracts. Chase provides a 5-day training period at no charge, so organizations can evaluate the engagement before making any commitment.
