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Proven Medical Billing, Coding & RCM Audit Services
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
What is a Medical Billing Audit?
Financial accuracy, fraud prevention, and compliance with regulations! Auditing is the answer to avoiding serious repercussions! We all know the general definition of auditing. In the context of medical billing, it is a structured process for evaluating the existing billing processes of a practice. To put it simply, medical billing audits verify three things: accuracy, completeness, and compliance of your records.
The primary goal? To improve your clean claim submission rates while maximizing your reimbursements. Because let’s be realistic, how can you expect growth when you continue making the same mistakes? That’s why successful practices frequently analyze their financial operations to identify billing inefficiencies. This may include incorrect coding, under or overbilling, or missing documentation that usually leads to claim denials, significant losses, or legal penalties. Hence, it is safe to say that medical billing audit isn’t just a choice anymore. It is necessary for long-term success, especially with the rising demands of insurance companies.
Types of Medical Billing Audit Services
Don’t overlook medical billing audits in favor of other billing tasks! Let us help you discover the main problems. At MediBillMD, we offer several types of comprehensive billing audits. However, our team mainly specializes in reviewing your aging AR, claim denials, and billing mistakes.
We understand that each practice has unique challenges and goals. Hence, We also offer custom audits at an additional cost. Our medical billing audit services include, but are not limited to the following:
Don’t give up on old claims – recover what’s recoverable! At MediBillMD, we analyze your aging AR to distinguish recoverable amounts from bad debts. Our accounts receivable audit helps you track overdue invoices and effectively manage cash flow by taking appropriate collection measures.
Discover the top 10 reasons for claim denials! At MediBillMD, we help you reduce claim denials by identifying ten recurring billing issues. Our team follows a strategic process to evaluate your existing denied claims. We also analyze your denial ratio to determine common trends and patterns in your denials.
Improve your average collection period! At MediBillMD, we also analyze how effectively you collect your accounts. Our medical billing audit team does that by comparing the ratio of collections to billed amounts. This also helps us to discover payment discrepancies and their root causes.
Avoid financial pitfalls! At MediBillMD, we identify the reasons for financial deterioration so you can address those problems. Our revenue leakage audit specifically highlights payment gaps within your billing processes, such as undercoding or unpaid claims.
Maintain complete and reliable financial records! At MediBillMD, we help you seal potential revenue leakage and payment delays. Our team reviews all your submitted claims and compares them with payments received to identify payment posting errors. We also actively monitor the status of your pending ERAs to identify additional requirements.
Identify areas of improvement! At MediBillMD, we also offer tailored analysis, such as the efficiency of your revenue cycle, AR turnaround, and claim acceptance rates, based on your requirements. Our team reviews your custom key performance indicators (KPIs) to assess your financial operations at an additional cost.
Key Benefits of a Medical Billing Audit
Frequent medical billing audits can help your practice in several ways.
Reduced Billing Errors
Billing errors, such as miscoding, duplicate billing, upcoding, incorrect patent information, and documentation, can easily lead to claim denials. Medical billing audits can help you identify these problems before claim submission. This ultimately improves your billing accuracy and financial stability.
Improved Compliance
Civil lawsuits, legal investigations, criminal charges, and even loss of medical license! Non-compliance with healthcare regulations can cost you your reputation. That’s why frequent medical billing audits are essential for identifying non-compliant areas or processes in your billing so you can take corrective measures and reduce legal risks.
Increased Revenue
Billing audits help you improve your revenue by uncovering hidden mistakes and increasing compliance with healthcare regulations. They also optimize your cash flow by helping you identify areas for improvement, including inexperienced staff or improper documentation practices.
Minimum Claim Denials
Audits are also important for identifying the causes of claim denials. By reviewing denied and current claims that are yet to be submitted, medical billing audits allow you to detect and resolve common billing errors. These may include coding mistakes, incomplete documentation, and compliance issues. This ultimately reduces your claim denial rates.
Better Patient Satisfaction
Did you know that patient satisfaction reflects the quality of a healthcare practice? Medical billing audits help you reduce your patients’ billing confusion and dissatisfaction by improving your billing accuracy and transparency. This leads to fewer billing disputes and faster payments.
Targeted Staff Training
Billing errors occur mostly due to human mistakes. Regular medical billing audits can help you identify the areas where your staff may need more education or training. In short, these audits create an opportunity for targeted training, allowing your team to improve their skills and make fewer mistakes.
Comprehensive Medical Billing Audit Checklist
Want to discover the billing problems that are costing you thousands of dollars? You may need a comprehensive medical billing audit checklist for that! A checklist is important because it serves as a blueprint for reviewing every aspect of the billing cycle. Additionally, it helps you identify common billing mistakes.
In simple words, a structured list simplifies the auditing process. So, instead of directly jumping into medical billing audits, create a list so you don't miss anything. Don't know where to start from? Begin by defining your auditing goals and breaking every task into manageable steps. You can include the following key elements in your checklist.
Patient Records Verification
Accurate patient information can help you file clean claims and avoid payment delays. So, while preparing a medical billing audit checklist, don’t forget to include patient information verification. This includes checking your patients’ personal details as well as verifying their insurance coverage.
Verify Coding Accuracy
Any medical billing audit checklist is incomplete without coding accuracy verification. This process involves confirming several things, including the correct use of specific diagnostic (ICD) or procedural (CPT) codes on medical claims with the appropriate modifiers. This review will help you avoid potential risks, such as miscoding and over- or undercoding.
Compliance with Payer Guidelines
Every insurance provider demands something unique and has different timelines for claim submissions. Review each company's specific requirements to make your processes more compliant and reduce claim denials.
Documentation Quality & Completeness
Documentation is the primary evidence of the provided services. Insurance companies assess medical documents to determine the medical necessity of the services and approve or reject claims. Hence, your checklist should also include this element so you can review the quality and completeness of your current records.
Denial Management Analysis
Are you effectively managing your denied claims? Include denial management analysis in your list to review its efficiency. This will help you identify the root causes of claim denials. Measure the percentage of denied claims with submitted claims to take corrective actions.
Regulatory Compliance
This is another key factor to analyze. Review your billing cycle to verify regulatory compliance with state and federal laws, including the Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA). This verification will help you protect patients’ privacy and legal penalties.
Why is MediBillMD the Best Medical Billing Auditing Company?
Cannot bear the high cost of non-compliance? Let MediBillMD reduce your financial and compliance risks! We proudly stand as the best medical billing auditing company due to our specialized approach and proven results. With years of experience in the healthcare industry, we guarantee accuracy, compliance, and maximum reimbursements via a comprehensive auditing process.
Our dedicated auditing team works tirelessly to find your billing inefficiencies and hidden mistakes with one simple goal – improving your overall financial health. Want to know what truly sets us apart from other billing names? Our special focus is on custom KPIs! Unlike general billing audits, our solutions track what matters the most to your practice. In short, our nationwide availability and commitment to accuracy and customer satisfaction make us the most suitable option for outsourcing medical billing audit services.
Post-Audit Medical Billing Services We Offer
We don’t just find the problems; we also fix them! Our post-audit medical billing services, including denial management, old AR recovery, coding, and billing, address all the issues discovered during auditing. By tailoring our solutions, we resolve all the payment discrepancies and ensure an optimized revenue cycle.
Our team reviews the billing audit results to guide you toward the next steps. We proactively work with your practice to manage and resubmit denied claims and outstanding balances. Additionally, we develop a reliable prevention strategy to minimize future denials. We set you on the path to success by maintaining regulatory compliance and improving your current billing processes.
How to Request a Medical Billing Audit?
Let us get your billing back on track! At MediBillMD, we offer medical billing audit services to optimize billing, coding, and documentation. Take your first step towards financial success by requesting a thorough medical billing audit. Reach out to our auditing experts to identify all the gaps in your revenue cycle.
- Fill out your information
- Specify the auditing type
- Book an appointment
- Submit the form
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