CareCode Pro Information

CareCode Pro helps hospitals, health systems, physician groups, health plans, and Medicare Advantage organizations simplify complex healthcare operations through AI-assisted coding, revenue cycle management, risk adjustment, medical record retrievals, denials management, CDI, RADV audit readiness, HEDIS, and quality programs. As healthcare organizations navigate rising denial rates, evolving CMS regulations, staffing shortages, and increasing audit scrutiny, CareCode Pro delivers scalable operational support that improves efficiency, strengthens compliance, and accelerates financial outcomes without adding complexity. Backed by a global team of certified coding, clinical, and revenue cycle experts, we operate as a seamless extension of our clients’ teams — improving reimbursement accuracy, reducing administrative burden, strengthening documentation integrity, and optimizing cash flow while providers stay focused on patient care. Our integrated delivery model connects provider and payer workflows across coding, compliance, retrievals, quality programs, and revenue cycle operations to reduce revenue leakage, improve operational visibility, and drive measurable performance at scale. Core Solutions: • Revenue Cycle Management (RCM) • Medical Coding • Risk Adjustment Coding • Medical Record Retrievals • Denials Management & A/R Follow-Up • Clinical Documentation Improvement (CDI) • RADV Audit Readiness • HEDIS & Quality Programs • Coding Audits & Revenue Integrity Proven Impact: • 96% coding accuracy • 25% reduction in denials • <30 days A/R performance • 15M+ charts processed annually • 500K charts/week scalable capacity • AI-assisted productivity gains • Multi-tier QA with audit-ready outcomes HIPAA Compliant | SOC 2 Aligned | HITRUST Framework | ISO 27001