Audit Checklist
Stop a 92% Failure Rate Before It Finds You.
Most denials and recoupments tied to Modifier 25 aren't coder errors — they're the output of EHR templates built to prevent denials, not pass audits. This checklist gives you the decision framework, audit instrument, and clinical scenario library in one place.
- The 4-question decision tree
- 25-chart self-audit template
- Defensible EHR template language
What's inside
The decision framework, audit instrument, and scenario library in one place.
Everything you need to make a separately identifiable E/M visible and defensible before the audit cycle arrives.
Where Modifier 25 Failures Come From
EHR templates auto-append Mod 25 to prevent denials and create recoupment exposure. The structural mechanism explained.
The 4-Question Decision Tree
Beyond the procedure, stands alone, documented separately, and right modifier for the global period — the exact test auditors apply.
The 25-Chart Self-Audit Template
Pull a stratified sample, run each chart through the four questions, and calculate your fail rate before the audit cycle does.
Six Clinical Scenarios: Right vs. Wrong
Including the exact intravitreal injection pattern OIG flagged at 92 percent failure. Each scenario shows the correct code, the common error, and why.
EHR Template Language That Holds Up
Three documentation constructs that make a separately identifiable E/M visible and defensible to any reviewer.
Quarterly Audit-Readiness Review
A recurring check to keep template behavior and coder practice aligned, so the fail rate stays low between formal audits.
Why RapidClaims
Built for the hardest coding challenges in healthcare.
While other vendors chase high-volume, low-complexity work, RapidClaims is built for the coding that actually moves your net collection.
>98%
Coding accuracy
Across 25+ specialties, including the complex ones competitors avoid.
40%
Fewer denials
Documentation gaps caught at the point of code, before submission.
170%
Coder productivity
More charts per coder — without adding a single FTE.
25+
Specialties supported
Depth in the hardest specialties, not just the easy volume.
82.5%
Charts auto-coded
Autonomous at an enterprise-grade accuracy threshold.
11k+
Organizations of signal
Operational data behind every coding recommendation.
Results
The numbers speak for themselves.
Trusted by Leading Healthcare Organizations
Connectivity
Works with your existing systems
RapidClaims integrates with all major EHRs. No rip-and-replace. No disruption.
Integration Capabilities
Security
Built for Healthcare. Secured for Enterprise.
SOC 2 Type II
Independently audited security controls
HIPAA
Full adherence to healthcare's most rigorous framework
HITRUST Ready
Aligned with healthcare's most rigorous framework
256-bit Encryption
Data encrypted at rest and in transit