Every record checked before it's billed.
Kodia Review checks every completed record before billing by independently re-coding it from the clinical documentation. The result is then compared with the hospital’s coding, so the billing team can focus its review on discrepant cases.
From coding to billing.
Kodia Review analyzes each run before invoicing. Records with no discrepancy detected do not require manual review, while discrepant cases are grouped into a targeted list for your billing team.
Analysis
Every record of the run is re-coded independently from the hospital documentation, against the catalogs in force.
Triage
Kodia’s coding is compared with the hospital’s coding. Records with no discrepancy detected do not require manual review.
Targeted list
Discrepant cases are presented to your billing team, ranked and accompanied by an explanation. In initial engagements, they represented approximately 25% of records; this rate varies by department and institution.
Expert review and submission
Your experts confirm, correct, or dismiss each case — then the run proceeds to submission.
A targeted selection for your experts.
For each billing run, Kodia identifies records with no discrepancy detected and presents discrepant cases to your team. Each discrepancy is ranked, explained, and accompanied by supporting information, so your experts can focus their attention where it is needed.
- Every record checked — coverage, not sampling
- Differences flagged in both directions: codes to question and codes you may have missed
- Data-quality or formatting issues are flagged separately for correction
Illustrative example
Inside your billing workflow, before the invoice.
Connect to your pre-billing flow
Review receives completed, coded records from your billing pipeline before invoicing. Transmitted data must be deidentified.
Re-code every record independently
Kodia codes each record from the clinical documentation without seeing the hospital’s coding, applying the TARDOC, outpatient flat-rate, and ICD-10 rules in force.
Compare, in both directions
Each record produces a comparison between Kodia’s coding and the hospital’s coding. Discrepancies may involve a billed position that Kodia did not select or a position identified by Kodia that is missing from the invoice. Data-quality or formatting issues are flagged separately.
Your experts decide
Discrepancies are presented to your experts in a ranked list, with the official references and supporting explanation. The expert confirms, corrects, or dismisses each finding: the decision remains yours.
Bill with a record of the check
Every record retains its review trail: what was checked, the discrepancies detected, and the decision taken by the team. Records with no discrepancy detected do not require manual review.
Independent second coding, not just a rule check.
Tariff validators check whether an invoice is formally permissible: cumulations, limitations, and qualifications. Review goes further by producing independent coding from the clinical documentation and comparing it with the existing coding.
- Analyzes the choice between a flat rate and TARDOC, beyond formal rule checks
- Finds documented services missing from the invoice, not just errors on it
- Every difference cites the catalog entries behind Kodia's view
"Is this invoice formally permissible?"
"Is this the coding a specialist would have produced from the documentation?"
Your coding, your call.
Review does not modify, approve, or block any record. It produces independent coding, a comparison, and supporting information; your team makes every decision. Responsibility for submitted invoices remains with your organization.
Start with one billing run.
For hospitals and ambulatory organizations that want systematic coverage of their coding before invoices go out.
Pilot
Run a Review pilot on one real billing run and evaluate the results with your coding team.
- Scoping, transfer of deidentified data, and connection to your pre-billing flow
- Full review of one billing run
- Results-list walkthrough with your coding experts
- Measured agreement and difference rates for your data
- Discussion of ongoing deployment
Subscription
Continuous review of every billing run. Pricing depends on volume and setup.
- Every record of every run, reviewed pre-billing
- Ranked list of cases for each run
- Number of sites and billing entities
- Integration with your billing system
- Reporting and support requirements
Looking back instead of forward? Kodia Audit examines your billing history as a one-time engagement and helps you assess whether ongoing Review would add value.
Check everything before it's billed.
Give us one billing run and see the cases your experts would have needed to review.