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Medical Billing & Coding Audit Services
Be On The Same Page with Your Payers & Patients!
AdvanceRCM provides healthcare providers with coding and compliance audit services. Our seasoned billing auditors meticulously examine billing codes to ensure accuracy, compliance, and real-time issue resolution optimization. Don’t jeopardize your practice; reach out to us today and let us assist you in achieving medical billing compliance.
What are Medical Billing Audits?
Medical billing and coding audits serve as essential evaluations to confirm that a provider’s billing claims and coding documentation comply with medical billing standards. Certified billing auditors carefully examine patient charts and billing records to ensure the accurate application of codes relevant to conditions and care provided. Analogous to routine physical exams detecting health issues early, audits identify billing issues, enabling providers to make necessary adjustments.
Audits play a critical role in uncovering incorrect coding, insufficient documentation, overlooked charges, and failure to comply with reimbursement standards. This proactive approach bolsters a provider’s revenue cycle by addressing errors before they result in denied claims or penalties for billing inaccuracies. Consistent, thorough audits offer multiple benefits, including ensuring accurate coding, complete records, maximizing reimbursement, adhering to payer policies, and promoting overall financial well-being.
How does Advance RCM Medical Coding Audit Company help?
Advance RCM operates as a reputable provider of professional medical billing audit services. Given the complexity of medical billing and coding, which is prone to errors, meticulous oversight is essential. Hence, our medical coding audit and compliance services offer this vigilant monitoring, acting as a safeguard to uphold the integrity of the entire medical claims billing process.
At Advance RCM, our seasoned billing auditors meticulously examine documentation, coding selections, and submitted claims to uncover inaccuracies and highlight areas for billing cycle enhancement. Our discoveries guide healthcare facilities towards flawless medical coding and comprehensive revenue capture.
Equally vital, our top-tier medical billing audit program prevents billing compliance breaches and fraudulent activities that result in fines, penalties, and compromised integrity. Consequently, our audit service stands as a cornerstone supporting clinical, financial, and regulatory excellence.
Auditing Your Coding Accuracy
Ensuring coding precision stands as a primary goal for our medical coding audit firm. We meticulously examine medical charts to guarantee that codes accurately reflect the diagnosis, performed procedures, and complexity level. Accurate coding is crucial for proper reimbursement and compliance with guidelines. Our audits uncover any instances of upcoding or under coding and propose corrective measures. With our support, physicians can trust that their coding meets standards and captures the full value owed.
Improving Your Charge Capture Accuracy
Another essential element we examine is charge capture. We validate that all services rendered and supplies used are captured in the billing at the appropriate rates. Missed charges lead to lost revenue. Our auditors diligently compare the documentation in the medical record to the itemized billing statement. We identify any missed charges and recommend improvements to charge capture processes. Our goal is to maximize your reimbursement by closing gaps where legitimate charges are overlooked.
Auditing Your Billing Documentation for Compliance
A comprehensive examination of documentation is integral to our billing audit procedure. We evaluate if the medical records offer coherent, uniform documentation that aligns with the coded claims. Clear, precise documentation is essential for validating charges and passing payer scrutiny. Our team identifies any documentation concerns such as ambiguity, discrepancies, absent signatures/credentials, or insufficient medical necessity. We offer recommendations to enhance documentation practices, ensuring stronger claim defense and audit resilience.
Performing Audits of Provider-Payor Contracts
We also scrutinize the correct implementation of insurance payer contracts and fee schedules, along with the accuracy of data inputted into the billing system. Incorrect fee schedules and data entry mistakes can hinder reimbursement. We confirm adherence to payer contracts and suggest enhancements to boost billing system precision. Our thorough audits encompass all essential aspects to optimize claim quality and revenue integrity.
