Reimbursement intelligence
Coding Compliance Software audit-ready by default
CLV Intelligence is coding compliance software that monitors CMS, MAC, NCCI, and OIG changes and turns them into audit-ready documentation — so your coding stays current, compliant, and defensible.
- 1,150+
- Policy alerts tracked
- 33
- Clinical specialties
- 7
- MAC contractors
- 15+
- Source families
Coding compliance is a moving target: NCCI edits change quarterly, the OIG Work Plan adds new audit focus areas, and LCD and NCD coverage criteria shift the documentation a clean claim requires. Falling behind any of them is how a compliant coding program drifts into recoupment risk. CLV Intelligence is coding compliance software that monitors all of those sources, flags what changed for your specialties, and captures source-linked, date-stamped records — so your program is current and your documentation is ready before an auditor asks.
Coverage
What CLV monitors across CMS
NCCI edit changes
Quarterly National Correct Coding Initiative edits — procedure-to-procedure and medically-unlikely edits — that drive front-end rejections.
OIG Work Plan
New and updated OIG Work Plan items that signal where federal audit attention is heading next.
Coverage criteria
LCD and NCD changes to medical-necessity and documentation requirements that define a compliant claim.
Coding guideline updates
Changes to official coding guidance, modifier rules, and reporting requirements.
Audit-ready records
Source-linked, date-stamped documentation of what you monitored and when — the trail a review expects.
Specialty-scoped
Every change mapped to the specialties you code, so compliance work stays focused.
How it works
From source to action, every day
We monitor the sources
CMS, every Medicare Administrative Contractor, and the Federal Register — scanned continuously, with the originating government document linked on every alert.
AI translates the impact
Dense regulatory text is distilled into the specialties, codes, and dollar exposure that actually affect your claims, then ranked by a signal score.
You act before it bills
Severity-ranked alerts with plain-language action guidance — plus audit-ready exports — reach the right team in time to change the claim.
Why automated monitoring
Why it beats manual source-watching
Compliance drifts quietly
No single change breaks a coding program — but quarter after quarter of missed NCCI edits and coverage revisions adds up to real recoupment exposure. Continuous monitoring stops the drift.
Documentation is the deliverable
In an audit, ‘we were watching’ isn’t enough — you need the dated, source-linked record. The platform produces it as a by-product of monitoring.
Focus beats firehose
Scoping changes to your specialties means your compliance team reviews what’s relevant instead of drowning in every federal update.
Who it’s for
- Revenue cycle leaders protecting net collections
- Coding professionals keeping pace with code and coverage changes
- Compliance officers building audit-ready documentation
- Healthcare finance executives quantifying reimbursement risk
- Reimbursement analysts replacing manual source-watching
- Specialty practice and billing-company leaders
Get CMS & MAC policy alerts by email — free
A weekly digest of the signal-scored changes that affect what you bill. No subscription required.
Frequently asked questions
What is coding compliance software?
Coding compliance software monitors the rules that govern correct coding and coverage — NCCI edits, OIG Work Plan activity, and CMS/MAC coverage and documentation requirements — and helps coding teams stay current and maintain audit-ready documentation. CLV Intelligence does this continuously and scopes changes to your specialties.
What are NCCI edits and why monitor them?
National Correct Coding Initiative (NCCI) edits are CMS rules that prevent improper code pairings (procedure-to-procedure edits) and implausible units (medically-unlikely edits). They update quarterly, and missing a change is a common source of front-end rejections — so they need continuous tracking.
How does CLV Intelligence support audit readiness?
Every monitored change is captured as a source-linked, date-stamped record, and alerts and exports document what your team was watching and when. That trail is exactly what a payer review, OIG inquiry, or accreditation survey expects to see — though it is not itself a legal compliance opinion.
Does it track the OIG Work Plan?
Yes. CLV Intelligence tracks new and updated OIG Work Plan items, which signal the billing and coding areas under federal audit focus, so your compliance program can prioritize accordingly.
Is CLV Intelligence a substitute for compliance or legal advice?
No. CLV Intelligence surfaces, summarizes, and signal-scores official policy changes so your team can act in time, but it is not legal, billing, or compliance advice and it is not an audit certification. Every alert links to the originating government source so you can review the exact language, and final interpretation should be confirmed with qualified compliance counsel.
Explore the platform
Denial prevention software
Catch denials before they bill
Revenue cycle intelligence
Policy risk mapped to net collections
CMS monitoring software
Track every CMS transmittal, NCD, and rule
ICD-10 alerts
Annual and mid-year ICD-10-CM changes
Specialty reimbursement alerts
CMS & MAC alerts mapped to your specialty
Stop finding out after the claim denies.
See the live feed of CMS and MAC policy changes, or talk to us about coverage for your team.