Process
OUR PROCESS
From Secure Intake to Billing-Ready — Codexpo’s End-to-End Coding & Compliance Workflow
Case Submission
Case Submission is the foundation of everything we do — just like a strong building starts with a solid base, accurate outcomes begin with a clean, complete submission. To stay compliant with HIPAA and CMS federal guidelines, all cases must be submitted via our secure, HIPAA-compliant Dropbox. Each submission is actively tracked and monitored to ensure nothing is lost, delayed, or overlooked — because our responsiveness is key to your agency’s success. Once received, our MD-led team conducts a thorough review of all documentation to identify any inconsistencies or missing information. If needed, a Correction Report is immediately sent to the agency to resolve issues before coding begins. Accurate documentation is critical, as even minor errors can lead to claim denials, compliance risks, or delays in reimbursement — making this first step one of the most essential in the entire workflow
OASIS Review & ICD‑10 Coding
OASIS Review & ICD‑10 Coding — 6‑Sentence “Quick‑Read”
OASIS data and ICD‑10 codes together determine up to 70 % of a home‑health episode’s reimbursement, so precision here is non‑negotiable.
At Codexpo, every chart is double‑checked: an MD‑led clinician performs the initial code set, then a senior auditor conducts a secondary OASIS validation.
We reconcile diagnoses with assessment findings, physician orders, medications, and functional scores to eliminate mismatches that trigger ADRs or claim denials.
All coding decisions are benchmarked against the latest CMS Grouper logic, PDGM guidelines, and quarterly ICD‑10 updates.
Turnaround is just two business days, keeping your agency’s workflow moving without bottlenecks.
The result is compliant, clinically sound documentation that maximizes reimbursement while standing up to any payer audit.
Pan Of Care (485)
Plan‑of‑Care (485) Completion — 6‑Sentence “Quick‑Read” (Home‑Health Focus)
The CMS‑485 Plan of Care is the physician‑signed prescription that governs every skilled home‑health visit, therapy, and supply for the episode.
After coding and OASIS validation are finalized, Codexpo’s dedicated Home‑Health 485 Team builds a complete plan—diagnoses, visit frequencies, goals, DME, and meds—in 4–5 business days.
Each line item is cross‑checked against PDGM rules, LUPA thresholds, and CoP §484.60 so nothing jeopardizes payment or survey results.
Automated logic flags missing face‑to‑face dates, conflicting orders, and home‑bound‑status wording before the form ever leaves our queue.
We send the 485 through a HIPAA‑secure e‑signature channel, making physician approval a one‑click task instead of a paper chase.
The outcome: a compliant, audit‑ready plan that releases billing on time and keeps patient care moving without interruption.
Cycle Complete — Ready for Billing
Your entire chart—ICD‑10 codes, OASIS assessments, and CMS‑485 Plan of Care—arrives back at your agency in a single, consolidated packet.
Every document has passed a dual‑layer audit for clinical accuracy, CMS compliance, and PDGM alignment, so you can bill with confidence.
HIPAA‑secure delivery keeps PHI protected while providing instant access for your billing and QA teams.
File names and metadata follow your naming conventions, making uploads to any EHR or clearinghouse friction‑free.
Turnaround times are guaranteed, so census surges never delay cash flow.
The result: compliant, audit‑ready documentation that moves straight from “Received” to “Billed” without rework or hold‑ups.
