Coding Advisor

An analytics and sequenced process-driven billing solution for payers that want to identify billing outliers, change provider behavior, and reduce overpayments of low-dollar, high-volume claims.

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Manage Healthcare Costs


Address losses on high volume low dollar claims.


Decrease provider abrasion through a collaborative solution delivering targeted messaging and educational data insights.


Drive positive change in billing abnormalities to help reduce mistaken claim submissions.


Help reduce E/M coding errors by educating physicians and their billing staff.


Increase medical cost savings for E/M services with provider self-auditing and coding validation.


Decrease the need for lengthy, costly, and abrasive audit activities.

Change Overbilling Behavior


Outlier identification

  • Identify coding outliers, comparing to the norm with peer analysis.
  • Establish baselines using a one year billing history compared to the billions of claims we process each year.
  • Benchmark provider billing behavior with advanced data analytics.

Educational outreach campaigns

  • Leverage real-time or next day targeted messages to alert personnel of their E/M outlier billing pattern based on a peer-to-peer analysis for claims processed through our Intelligent Healthcare Network.
  • Provide important program information with proactive messages that prompt providers to make corrections and request self-validation of the original coding before resubmitting the claim.
  • Educate providers and staff on billing policies with outlier reports, outreach phone calls, and scheduled office visits from Chane Healthcare experts.

Validation and action

  • Allow Change Healthcare to monitor and evaluate program adoption, and conduct probe audits on those outlier providers whose behavior has not yet changed.
  • Build lines of communication between payer and provider with an inclusive approach of education, outreach, and collaboration that rivals traditional post pay programs.
  • Depend on Change Healthcare to prepare documentation, case summary, and action plan for the payer SIU team.

Providing Measurable Value

  • 80.1%

    outlier providers exhibiting better accuracy

  • 34.7%

    avg. decrease in overbillings

  • $2-$4

    PMPY medical cost savings

Talk to Sales 1-866-817-3813

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