Symbion Coding

Symbion Coding is a healthcare consulting firm founded in 2018 that specializes in medical coding, billing compliance, and revenue cycle optimization. The company focuses primarily on Medicare risk adjustment, clinical documentation improvement, and chart auditing services for health plans, managed service organizations, and medical providers.

The firm offers three core service lines: medical chart reviews (both retrospective and prospective), M&A due diligence for healthcare acquisitions, and coding and billing compliance audits. Their approach combines expertise in both inpatient and outpatient coding, including DRG validation, HCC coding accuracy, and E/M service documentation. The company achieved SOC 2 Type II certification in 2025.

Led by founder Jean Delva, who brings 15 years of Medicare risk adjustment experience, the team includes credentialed professionals holding RHIA, CCS, CCS-P, and CDIP certifications. The company has worked with notable clients including InnovaCare Health (which operates over 30 clinics) and ClareMedica Health Partners, helping organizations identify revenue opportunities and maintain regulatory compliance.

Choose Symbion Coding when you need specialized Medicare risk adjustment expertise, particularly for HCC coding accuracy or value-based care documentation. Their boutique approach provides personalized attention with credentialed professionals who understand the nuances of both clinical documentation and regulatory compliance.

Expect a consultative partnership rather than transactional outsourcing. The flat-fee pricing structure aligns incentives, and their three-step process (compliance planning, ongoing monitoring, and in-depth auditing) provides continuous support rather than one-time assessments. Organizations undergoing M&A activity will benefit from their specialized due diligence capabilities that specifically assess coding and billing risk.

Symbion Coding operates exclusively in healthcare with particular concentration in Medicare Advantage and risk adjustment programs. Their services directly address CMS requirements, RADV audits, and Medicare risk adjustment model compliance. The team's certifications (RHIA, CCS, CCS-P, CDIP) are healthcare-specific credentials from AHIMA.

Their specialization extends to ACO quality reporting, clinical documentation improvement for risk-bearing organizations, and regulatory compliance for value-based payment models. The company understands the financial implications of accurate HCC capture and documentation completeness in Medicare reimbursement.

The ideal client is a Medicare Advantage plan, ACO, or primary care organization with 5-50 providers operating in value-based care arrangements. Organizations that have identified compliance gaps, are preparing for CMS audits, or are acquiring other healthcare entities will find their services particularly relevant. Clients should value ongoing partnership over transactional project work.