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Outpatient Services represent a fast growing segment in healthcare expenses today.


The Ambulatory Payment Classification (APC) prospective payment system is a system designed to define and explain the amount and type of resources used during a single outpatient visit. APCs are defined solely on the CPT procedure codes. In arriving at a final payment amount for each visit, the system packages certain predefined services performed during the same visit. These services include those that do not require significant added time and resources or that are routinely performed with certain diagnoses and/or procedures, such as xrays and casting a fracture. APCs are used to determine outpatient hospital reimbursement.

Our audit services validate the CPT procedure codes and other factors for payment accuracy.


Therapies (physical, speech and occupational), laboratory services, ambulance and screening mammography are typically paid based upon an established fee schedule in the outpatient hospital environment.

Our audit services validate ancillary services to ensure payment integrity.

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