Alpine Pro Health delivers certified, AI-assisted Inpatient Diagnosis Related Group (IP-DRG) coding — ensuring accurate assignment, full compliance, and optimized reimbursement for hospitals and health systems across the U.S.
Medical coding is the transformation of healthcare diagnoses, procedures, medical services, and equipment into universal alphanumeric codes. These codes — drawn from ICD-10-CM/PCS, CPT, HCPCS, and HCC systems — are the foundation of every claim submitted to payers for reimbursement.
Inaccurate or incomplete coding doesn't just reduce revenue — it exposes your organization to audit risk, claim denials, and compliance liability. Alpine Pro Health's certified coders and AI-powered workflows ensure every code is captured correctly, every time.
From inpatient facilities to physician practices — our certified coders and AI tools cover every aspect of your revenue cycle.
Capture chronic conditions accurately with Hierarchical Condition Category coding. Ensures fair payer reimbursement, CMS compliance, improved patient outcomes, and optimized Medicare Advantage performance.
Accurate classification of hospital stays capturing diagnoses, procedures, and comorbidities. Supports optimal DRG reimbursement, reduces audit risk, and ensures full compliance with payer and CMS IPPS guidelines.
Accurate, timely capture of high-acuity patient encounters. Ensures proper E&M level assignment, minimizes audit risk, and reflects the true complexity of emergency care provided.
E&M, surgery, radiology, and lab services coded to the correct level of service. Maximizes reimbursement while maintaining full compliance with payer-specific and CMS guidelines.
Specialized abstraction services extracting structured clinical data from oncology records for registry reporting, research, quality performance metrics, and value-based care programs.
Pre-bill and retrospective coding audits to reduce RAC, OIG, and payer audit risk. Identify gaps before they become liabilities and build a culture of ongoing coding accuracy.
Collaborative Clinical Documentation Improvement programs that bridge coding and clinical teams — improving specificity, completeness, and accuracy across all payer types.
Expert-led coding appeals for denied claims with detailed clinical justification letters. Peer-to-peer review support and root cause analysis to prevent recurrence.
GenAI and LLM-powered tools that accelerate chart review, surface documentation gaps, and recommend codes — validated by our certified coders for accuracy and compliance before submission.
We combine certified expertise, advanced AI technology, and deep coding knowledge to deliver measurable results across all specialties and care settings.
A streamlined, HIPAA-secure workflow from chart intake to accurate code delivery — with zero compliance gaps.
Secure EHR access or encrypted chart upload. Documentation assessed for completeness and medical necessity.
GenAI engine flags HCC gaps, CDI opportunities, missing diagnoses, and code suggestions before coder review.
CPC-certified coders assign ICD-10-CM/PCS, CPT, HCPCS, and HCC codes with clinical precision.
Multi-level audit against payer, CMS, and OIG guidelines. Denials risk flagged before submission.
Coded charts delivered to your billing system with coder notes and documentation improvement queries.
Our certified coders are proficient in every code system required across U.S. physician and facility billing.
Our coders carry deep specialty expertise across the highest-complexity and highest-value service lines in U.S. healthcare.
High-reimbursement procedures with complex DRG sequencing
Stroke, craniotomy, spinal procedures, and cognitive disorders
Joint replacements, fracture care, and musculoskeletal procedures
Complex malignancy coding with clinical abstraction support
Every coding workflow is designed around the latest CMS, OIG, and payer requirements — keeping your organization protected and audit-ready.
All inpatient and outpatient coding aligned to the latest CMS Inpatient and Outpatient Prospective Payment System rules and annual updates.
Coding decisions are documented and defensible, with focus on high-risk areas historically targeted by RAC, MAC, CERT, and OIG auditors.
Strict adherence to ICD-10-CM Official Guidelines, CPT Editorial Panel guidance, and AHA Coding Clinic direction for all code assignments.
All PHI handled under HIPAA-compliant protocols with encrypted transfers, SOC 2-aligned infrastructure, and signed Business Associate Agreements.
Coding aligned to Medicare, Medicaid, commercial, and managed care payer policies — including UHC, Anthem, Aetna, BCBS, and Cigna plans.
Physician Quality Reporting, MIPS/MACRA data capture, and value-based care performance metrics tracked and reported with accuracy.
All Alpine Pro Health coders hold active AAPC or AHIMA credentials relevant to their specialty — including CPC (Certified Professional Coder), CCS (Certified Coding Specialist), CIC (Certified Inpatient Coder), and RHIA/RHIT designations. Our coders maintain continuing education requirements and stay current with annual ICD-10 updates, CMS final rules, and Official Coding Guideline changes.
We support integration with over 200 EHR and practice management platforms including Epic, Cerner, Meditech, Allscripts, eClinicalWorks, and Athenahealth. Our team can access your system remotely through secure VPN, or work with chart exports delivered via encrypted SFTP. Coded data is returned in your preferred format including 837I/P files, direct system entry, or structured workbooks.
Standard outpatient and professional fee accounts are typically coded within 24 hours. Inpatient and complex surgical accounts are completed within 24–48 hours. For DNFB backlog clearance projects, we provide a detailed project timeline with milestone reporting. We also offer concurrent inpatient coding programs that align with your facility's daily discharge workflow.
Our GenAI and LLM-powered tools perform a pre-analysis of each chart before a human coder reviews it. The AI surfaces potential diagnoses, flags documentation gaps, recommends HCC codes, and highlights CDI query opportunities. All AI suggestions are reviewed and validated by a certified coder before submission — the AI accelerates the workflow, but human expertise and accountability remain central to our process.
Our denials management team reviews all coding-related denials, prepares detailed clinical coding rationale letters, and supports peer-to-peer reviews when required. We analyze denial patterns by payer, code category, and provider to identify systemic issues and implement corrective action. Our appeal success rate for coding-related denials consistently exceeds 80%.
Yes. Our dedicated HCC coding team specializes in prospective, concurrent, and retrospective risk adjustment coding for Medicare Advantage and ACA plans. We perform comprehensive chart reviews to identify all documented chronic conditions, close HCC gaps, and ensure accurate risk scores — supporting both your revenue and your quality performance under value-based care contracts.
Partner with Alpine Pro Health's certified coders and start capturing every dollar your facility has earned — compliantly, accurately, and efficiently.
Established in 2022, Alpine Pro Health. delivers accurate, compliant, and efficient medical coding and RCM solutions. Trusted by U.S. healthcare providers for expert-driven, end-to-end services.
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