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Precision in Every Code. Accuracy in Every Claim.
You saw the patient and documented the visit. Then the claim denied because a diagnosis was miscoded, a modifier was missing, or the record didn't support the level billed. Qualigenix codes every encounter to the documentation and to CMS rules, so charts leave clean and hold up in an audit. Certified coders, 98.9% accuracy, 38+ specialties
What are the benefits of medical coding services from Qualigenix?
Qualigenix codes at 98.9% accuracy and keeps over- and undercoding under 2%, so more claims pass on first submission and fewer come back as coding denials. Specialty-certified coders assign ICD-10-CM/PCS, CPT®, and HCPCS Level II inside your existing system across 133 EMR and EHR platforms, and they query missing documentation instead of coding around it. Every chart runs through two levels of QA, so accuracy is scored by coder and specialty rather than assumed. You also get HCC risk-adjustment coding for value-based contracts, audit-ready charts backed by prospective and retrospective review, and monthly reporting where every figure carries its definition. Onboarding takes 6 days on average, so there is no coding backlog during the switch.
The revenue your practice actually keeps
PRECISION
| Metric | Result |
|---|---|
| Coding accuracy rate | 0 |
| Post-audit coding accuracy | 0 |
| Compliance / audit pass rate | 0 |
| Over- and undercoding rate | 0 |
| Charts coded per month | 0 |
PROGRESS
| Metric | Result |
|---|---|
| Coding-related denials | 0 |
| Specialties coded | 0 |
| Charts coded per month | 0 |
| Charts audited per quarter | 0 |
| Reduced to under 1% | 0 |
WHAT CLIENTS SAY
What our clients say about this service
“
Qualigenix helped our radiology center improve the accuracy of our coding and ensure that patient financial responsibilities were determined correctly. Their team provided reliable guidance on coding while accurately identifying copays and deductibles for patient encounters. Their attention to detail and expertise gave us greater confidence in our billing and helped reduce the risk of errors and unexpected patient balances. Qualigenix has been a valuable partner in making our revenue cycle more accurate and efficient.
Dr. Shyam Murthy
CEO • New Era Imagining Center, LLC
“
Accurately identifying and billing J-codes was a major challenge for our pain management practice, and we were concerned about missing out on appropriate reimbursements. Qualigenix brought the expertise we needed to identify the correct codes and billing requirements. Their attention to detail helped us submit claims more accurately and ensure we received the reimbursements we were entitled to. Their knowledge of pain management billing made a significant difference to our practice.
Dr. James R
Owner • Private Practice
PRECISION
What Qualigenix does at every stage of the claim
Qualigenix owns each step of the billing cycle so nothing falls between your front desk and the payer. Specialty-certified coders and dedicated billers handle the work inside your system, not a bolt-on portal.
Clinical documentation review
Coders read the physician notes, diagnostic results, and procedures before assigning anything, and flag gaps or conflicts instead of guessing at intent.
Compliant code assignment
ICD-10-CM/PCS, CPT®, and HCPCS Level II are assigned and sequenced per CMS and payer rules, with medical necessity checked against LCD and NCD policy.
Modifier accuracy
Modifiers (25, 59, 26, TC and others) are applied only when the record supports them, so charts don't trigger avoidable edits or bundling denials.
CDI query management
When documentation won't support a defensible code, coders raise compliant, non-leading physician queries and track response time, keeping an audit trail.
Two-level quality assurance
A peer or auditor review is followed by random statistical sampling, with accuracy scored by coder, specialty, and client to hold the rate at 98.9%.
Risk adjustment & audit readiness
HCC coding and risk-score review support value-based contracts, and prospective and retrospective audits with DRG validation keep charts ready for a CMS review.
ONBOARDING TO STEADY STATE
How Qualigenix medical billing works
1
Kickoff & scope definition
BAA and SLA executed; a named coding lead is assigned to your account
Scope set across IP, OP, ER, ASC, ProFee, facility IP, and HCC
Code sets confirmed: ICD-10-CM/PCS, CPT®, HCPCS Level II
Payer mix and specialty coverage mapped before any chart is coded
2
Coder assignment & record intake
Specialty-certified coders matched to your specialty mix
Secure chart intake from your EHR or document management system
Chart completeness check (H&P, op notes, discharge summary)
Encounter type validated and cases prioritized by SLA and payer rules
3
Playbook & guideline setup
A coding playbook and client-specific guidelines are built to your specialties
Productivity and accuracy benchmarks agreed against your SLA
CMS and AAPC compliance standards documented for the account
EHR, encoder, and CAC access provisioned across supported platforms
4
Documentation review & queries
Coders review notes, results, and procedures before assignment
Documentation gaps and conflicts identified and flagged
Compliant, non-leading CDI queries raised where records fall short
Query response time tracked with a full audit trail
5
Code assignment & QA
ICD-10, CPT®/HCPCS, and modifiers assigned and sequenced per CMS rules
Medical necessity validated against LCD and NCD policy
First-level peer or auditor QA, then statistical sampling
Errors categorized as clinical, technical, guideline, or modifier/sequencing
6
Go live & continuous improvement
Coded encounters exported daily to your billing or claims system
Denial root-cause analysis feeds back into coder education
Accuracy and productivity dashboards delivered on a set cadence
Your named account contact and reporting schedule are set
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HAVE QUESTIONS?
Frequently Asked Questions
A medical coding service translates each clinical encounter into ICD-10, CPT, and HCPCS codes a payer will reimburse, after reviewing the documentation that supports them. Qualigenix runs this across 38+ specialties with specialty-certified coders, two levels of QA, and CDI query support, coding at a 98.9% accuracy standard so claims pass on first submission and hold up in an audit.