Billing, Coding & Auditing

Juris Medicus has medical billing, coding, and auditing experts who are certified by the American Academy of Professional Coders (AAPC).

One of the most important items in injury cases is the cost of medical bills. Understanding medical costs can be complicated and experienced guidance by a billing and reimbursement expert is critical to ensure a clear understanding of what is “fair and reasonable” regarding finances involved in medical care.

Billing and coding experts are individuals who review medical coding and billing to ensure claims submitted for payment by the provider are usual, customary, and reasonable (UCR). A medical charge is considered “usual” if it is similar to what a provider has previously charged other patients, thus establishing regularity in their practice. A “customary” charge is the fee for medical service compared to the fee typically charged by other medical providers who practice the same type of medicine, and who are in the same region.

A medical charge is “reasonable” if it is both usual and customary or if the service was medically necessary to save a patient’s life. An expert medical auditor is qualified to review medical records, billing data, administrative data, and coding records to ensure compliance with federal and state industry regulations.