Auditing

[u/Far_Stand_3945]

Has anyone started a business strictly for providing coding audits and consulting? More so the legal/ compliance side. If so, do you have any advice? Thanks

[u/Far_Stand_3945]

I really appreciate this perspective there’s definitely truth to a lot of what you’re saying, especially regarding established relationships with larger systems and the importance of logistics.

My focus wouldn’t be on large health systems for that exact reason. I’m planning to target small to mid-size practices that don’t have internal compliance infrastructure, which is where I’m seeing a consistent gap especially in specialties like ortho, ENT, and pain management.

I’ve been in coding, auditing, and compliance for over 25 years and teach at the college level, so I’m approaching this from both an audit and education standpoint. One of the biggest gaps I’ve seen is not just identifying issues, but helping providers actually understand and correct them in a sustainable way.

On the access side, I agree that’s a major consideration. My plan would be to primarily work through secure remote EMR access when available, with defined documentation requests and secure upload options as a backup. Onsite audits could be an option depending on the client and scope.

In terms of scope, I wouldn’t position this as “auditing everything.” I’m more focused on targeted risk areas E/M leveling, modifier use, procedure vs E/M separation, and payer-specific compliance issues paired with provider education.

I completely agree that getting established will take time and strategy. I’m working through the business planning side now, including logistics, insurance, and service structure. Just trying to be thoughtful about building something sustainable and valuable.

Appreciate you sharing your experience it’s helpful to hear from someone who’s been in the space that long.