Toni P.

Toni M. Parks, MBA-HCM, CVBA, CDEO, CDEI, CRCR, CPC, CSBI, CPPM Value Based Care | Clinical Documentation Integrity | Coding Compliance I'm a healthcare consultant with over 30 years of experience across clinical laboratory operations, medical and surgical group practice, EMS, and healthcare administration. In my full-time role as Senior Manager of Medicare Risk Adjustment at a medium-sized physicians' group, I see firsthand how documentation quality drives risk capture, reimbursement accuracy, and audit exposure, and I bring that same frontline perspective to every consulting engagement. Through my consulting practice, I help healthcare organizations improve risk adjustment accuracy, strengthen clinical documentation integrity, and build compliance frameworks that hold up under audit, so providers can focus on patient care instead of paperwork. My engagements range from hands-on coding and auditing support to customized provider and staff education, built around each organization's specific needs. Core Competencies Medicare Risk Adjustment & HCC Coding: Expert-level auditing and coding to ensure accurate risk capture, close documentation gaps, and support compliant RAF optimization across Medicare Advantage and ACO populations. Clinical Documentation Integrity (CDI): Provider education, query development, and documentation improvement that increases specificity, supports accurate code assignment, and reflects the true complexity of patient care. Compliance Plan Development: Compliance strategies aligned with OIG guidance, CMS regulations, and payer requirements, including internal audit programs and corrective action planning. Revenue Cycle Management: End-to-end support from charge capture and coding through denials management, payer contract review, and collections performance. Provider & Staff Education: Webinars, audit-based coaching, and customized training on HCC coding, CDI, E&M documentation, telehealth billing, and compliance, for physicians, APPs, MAs, and administrative staff. Internal Auditing: Prospective and retrospective audits that catch documentation gaps, coding discrepancies, and compliance vulnerabilities before they become payer or OIG issues. Physician Practice Management: Operational efficiency, HR and payroll support, and financial planning, drawing on my CPPM credential and decades of hands-on practice experience. I take a collaborative, practice-first approach, working alongside your clinical and administrative teams to build processes that are compliant and sustainable to run. Whether you need a full risk adjustment program assessment, targeted provider and staff education, or ongoing coding and audit support, I tailor the engagement to your goals. Let's talk about how I can help protect your revenue and reduce your compliance risk. I'm happy to share sample audit findings or a resume tailored to your needs.