Detailed Medical Billing Audit Services for Practice | I-Med Claims (2024)

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    Medical Billing Audit

    Our medical billing audit experts are here to provide you with a detailed analysis of your practice

    Medical Billing

    Our team of medical billers is fully able to provide you with clean claim submissions in no time.

    Eligibility Verification

    We offer quality Breakdown of Benefits and Eligibility Verification services at affordable rates.

    Denial Management

    We focus both on denial prevention and management to make sure the practice remains financially stable.

    Account Receivables

    We will make sure that your Account Receivables remain low and your overall revenue collections remain high.

    We handle detailed documentation and provide medical practices with hands-on credentialing.

    Detailed Medical Billing Audit Services for Practice | I-Med Claims (8)

    Service Fee Starting From @2.95%Of Monthly Collections

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  • Revenue Cycle Management
    • Medical Billing Audit
    • Medical Billing
    • Eligibility Verification
    • Denial Management
    • Account Receivable

    Medical Billing Audit

    Our medical billing audit experts are here to provide you with a detailed analysis of your practice

    Medical Billing

    Our team of medical billers is fully able to provide you with clean claim submissions in no time.

    Eligibility Verification

    We offer quality Breakdown of Benefits and Eligibility Verification services at affordable rates.

    Denial Management

    We focus both on denial prevention and management to make sure the practice remains financially stable.

    Account Receivables

    We will make sure that your Account Receivables remain low and your overall revenue collections remain high.

    We handle detailed documentation and provide medical practices with hands-on credentialing.

    Detailed Medical Billing Audit Services for Practice | I-Med Claims (15)

    Service Fee Starting From @2.95%Of Monthly Collections

    Schedule Appointment

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    • Family Practice
    • Internal Medicine
    • Pediatric
    • Cardiology
    • Nephrology
    • Urgent Care
    • View All

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Detailed Medical Billing Audit Services for Practice | I-Med Claims (17)

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Get A Detailed MEDICAL BILLING AUDITFor Healthcare Practices

Our Team helps you to reduce billing compliance issues

Simplify medical billing audits across all your departments by partnering with leading medical billing providers and coding partners for 24-hour medical billing services. When it comes to documentation or other audit-related tasks, there’s no fuss because we handle patient data securely.

Moreover, medical billing audits enhance and strengthen billing andcodingprocesses, ensure stricter claims processes, and demonstrate that all necessary measures are in place to avoid future errors. Plus, ensure proper revenue cycle management (RCM) processes are set to increase income.

Our expert medical billing audit team consists of compliance officers, finance managers, case managers, IT, medical advisors, and HIMs. They ensure that the medical practices can not only meet regulatory requirements. But also streamline processes and workflows to ensure higher profits through the claims process is the most rigorous and efficient.

Benefits to hire i-med claims

  • Enhanced cash flow
  • 99% Claim Rate
  • Minimize A/R delays
  • Starts from 2.95% of your collections
  • Fewer claim denials and rejections
  • EHR Flexible Solutions
  • Dedicated Team of 1000+ Experts

Take control of your medical billing with a thorough audit.

Detailed Medical Billing Audit Services for Practice | I-Med Claims (18)

What Is A Medical Billing Audit?

A medical billing audit is a process performed to evaluate clinical documents. Verify the accuracy, reliability, and validity of records maintained by medical facilities and review billing documents submitted to taxpayers. Auditing allows for the detection, monitoring, and correction of inappropriate billing practices.

A medical bill audit is a complex process. You will need to manage many data sources, including clinical records, financial records, accounting documents, and policy-related documents. Therefore, it is very important to gather all the information in one system and arrange it correctly

The Medical Practice Audit Process

Medical Billing Audits are considered to be crucial for the operational and financial performance of a medical practice. The process is rather simple, yet complicated because of several factors contributing to a smooth revenue cycle for medical practices.

An Internal Medical Billing Audit is highly involved in the financial affluence of medical practices as it gauges the strengths and weaknesses of the practice in order to improve its performance. Medical practices can simply type “medical practice audit companies near me” to find a quality billing company that can carry out an audit and help you improve your revenue collections and decrease account receivables.

Why Is Medical Billing Audit Important?

Auditing is an essential function in every business, in every industry. It is a great tool to ensure efficient management of revenue following rules and regulations and to identify the need to improve internal procedures. This is especially true for physicians when it comes to medical claims. Medical billing audits are two ways to improve the process of medical practice. The first is to contact the claims administrator. The second type of medical billing audit is an audit of your own business to find areas of error and how to improve the mistakes you’ve made.

Managing medical bills can be complex and costly if not managed properly. Some reasons why a medical claims audit may be required include identifying errors in medical billing audits, identifying ways to increase the likelihood of recovery, and ensuring that medical practices adhere to the latest compliance rules regarding medical claims.

Detailed Medical Billing Audit Services for Practice | I-Med Claims (19)

Your Practice is in Secure Hands!

Yes, Medical Practices! With I-Med Claims your RCM billing audit is in safe hands, we are a completely professional and HIPAA-compliant billing company that ensures data protection. This is why it is always a good idea to outsource your billing audit to our medical billing auditors who will provide you with an eagle-eyed view of your medical practice. With our audit services, you can grow your practice without worrying about revenue leakages destroying your revenue collection rates.

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Detailed Medical Billing Audit Services for Practice | I-Med Claims (20)

Medical Billing Audits Made Secure with HIPAA Compliance

The Medical Billing Audit process is a good way to see the bigger picture when it comes to your medical practice and its overall performance. It allows you to fix all revenue leakages and contribute to better revenue cycle management. However, for medical practices, these medical billing audit templates have to be outsourced to those RCM billing companies that are completely HIPAA compliant and ensure the protection of Private Healthcare Information [PHI]. As a result, your medical practice can benefit from the audit while staying assured regarding the security of your patient’s healthcare information.

The RCM Medical Billing Audit Checklist

An audit checklist is essential for a billing and audit company to navigate the entire process. It helps in tracking all possible revenue leakages and contributes to a better revenue cycle. This is why Medical billing audits are highly critical to ensure the accuracy as well as integrity of billing practices and to prevent revenue loss and financial distress.

Checklist:

  • Initially, search and verify the valid patient IDs.
  • Verify that all the patient demographic information is accurate and complete.
  • Ensure that the correct coding and billing of services are executed.
  • Review the accuracy of all insurance information and payment processing.
  • Ensure that claims are submitted within the required deadline.
  • Check for duplicate billing and proper use of modifiers
  • Verify the appropriateness of documentation supports the services billed
  • Ensure that all applicable adjustments or discounts are implemented accurately.
  • Evaluate ethical and legal compliance with local, state, and federal regulations in order to avoid any kind of litigation.

Thus, we can say that a regular medical billing audit offers many benefits, such as improved revenue cycle management, compliance with legal rules, and low account receivables. As a result, increased financial stability for healthcare providers is ensured along with higher patient satisfaction.

Maximize Your Reimbursem*nts - Schedule a Medical Billing Audit Today!

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Medical Billing Audit Types

Medical billing audits and medical billing claims are available no matter the size of your business. Conducting regular audits can help ensure that your medical billing system is efficient and has sufficient cash flow.These are some of the types of reviews that are done in the medical field:

Sampling Audit

Conduct medical billing audits this way and select claims based on insurance funds that cover both small and large claims. Perform an audit. The focus is on dollar amounts, not the number of shares being analyzed. A random audit doesn’t mean you’ll receive a refund from your insurance company, but it may help complete a more thorough audit review.

Full Audit

The review is extensive and examines claims that have previously been audited manually or electronically. Additionally, it allows you to make claims to the claims administrator, which is the main goal of auditing.

Hybrid Medical Billing Audit

Hybrid medical billing audits combine random sampling audits with comprehensive audit reviews to achieve results including chargebacks and compliance. Additionally, it focuses on recovering overpayments quickly.

Benefits of a Medical Billing Audit

Self-auditing is not officially recognized by the federal government and is only encouraged by CMS.According to CMS (Centers for Medicare & Medicaid Services), medical practices may gain the following benefits from Medical Billing Audit.

Prevent and reduce the use of fraudulent payments

A medical bill audit is a way to check your regular and irregular payments. They can also guide you to make necessary changes with your claims company. Additionally, it helps identify the reasons for the late payment of medical claims/billing systems and gives you a clear view of improvements and best practices. It will help you deal with fewer payment issues and prevent money from going to medical clinics.

Make sure you file your claim accurately

Medical Bill Checker allows you to check every area of ​​your medical bill and submit and process claims. Future claims will be processed and will not be rejected by the insurance company. If you file a claim correctly and accurately, your revenue will increase, which will increase patient satisfaction.

Improve the rate of patient care

Regular medical billing audits can help you get immediate reimbursem*nt and increase your focus on the care of your visiting patients. Without the complexity of medical billing or claims processing workflows, you can run your business more efficiently while spending more time with your patients.

Minimize the risk that an external auditor will be able to audit your company

There is no need to spend time and effort on an external review when a physical examination performed internally is sufficient to provide possibilities for improvement and to identify areas of non-working.

Instant feedback on employee performance

Internal medical audits are an opportunity to immediately identify employee performance and direct employees to areas that need improvement. Plus, it provides accountability for team mistakes to ensure they are more accountable.

Costs, Benefits, and Compliance

Auditing helps your practice identify where you can withdraw funds that are overdue or in the process of withdrawing, and develop new procedures and policies to ensure your employees do not repeat mistakes. Therefore, auditing is beneficial in terms of compliance and cost.

Weak link description

Because Internal Medical Billing Voice lets you know how well your employees are doing with filing health bills and claims. They can also receive proper training in areas where they struggle.

Call us today for the best Medical Billing Audit Service in the USA By I-Med Claims

Get 24/7 medical billing support from our expert team. Our in-house medical billing auditors offer comprehensive, specialized assistance to help balance your work and life. Contact us now!

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Detailed Medical Billing Audit Services for Practice | I-Med Claims (2024)

FAQs

How to audit medical claims? ›

What are the key steps in a medical claims audit?
  1. Step One: Assemble your claims review team. ...
  2. Step Two: Pull a sample of your medical claims. ...
  3. Step Three: Carefully review each claim for accuracy. ...
  4. Step Four: Make a list of mistakes and discrepancies. ...
  5. Step Five: Organize audit findings in a report.
May 11, 2021

What is an audit in medical practice? ›

Clinical audit is a way to find out if healthcare is being provided in line with standards and lets care providers and patients know where their service is doing well, and where there could be improvements.

What is one reason why medical records would be audited? ›

One reason why medical records would be audited is to ensure compliance with legal and regulatory requirements. Auditing helps to identify any discrepancies, errors, or fraudulent activities in the medical records.

How to do a simple medical audit? ›

  1. CHOOSE A CLINICAL AUDIT TOPIC. Your topic should be chosen systematically. ...
  2. FORM A PROJECT TEAM. ...
  3. SET THE AIM, OBJECTIVES AND STANDARDS. ...
  4. ETHICS & ENGAGEMENT. ...
  5. SELECT AN AUDIT SAMPLE. ...
  6. PLAN AND CARRY OUT DATA COLLECTION. ...
  7. ANALYSE THE DATA. ...
  8. PRESENT THE FINDINGS.

What does a billing auditor do? ›

It's a thorough review conducted to ensure that the claims submitted to insurance companies are accurate and compliant with legal and health policies. A medical billing audit is when experts review and inspect the medical bills and records to make sure everything is correct and follows the rules.

What is a medical claims auditor job description? ›

Job Duties

Conduct pre-pay audits of claims when appropriate. Summarize and report individual and team results. Maintain productivity standards to effectively handle multiple, concurrent priorities and consistently meet established deadlines.

What is claim audit process? ›

A claims audit aims to identify any discrepancies or inaccuracies in the documentation and records that the policyholder may have submitted. This process helps the insurer verify that the submitted claims are eligible for reimbursem*nt or payment.

Who conducts medical audits? ›

The top dog in healthcare auditing is the Department of Health and Human Services (HHS). But with 629 different rules and regulations to administer, HHS as a single entity can't do it alone.

What are the 5 stages of audit? ›

What happens during an audit? Internal audit conducts assurance audits through a five-phase process which includes selection, planning, conducting fieldwork, reporting results, and following up on corrective action plans.

What are the duties of a medical auditor? ›

As a medical auditor, you audit coding, billing, and organization systems to ensure accuracy. Additional auditing duties consist of analyzing medical records, Medicare programs, and billing records. A medical auditor's primary objective is to maintain quality by recommending improvements to medical coding systems.

What are the steps of auditing? ›

Audit Process
  • Selection.
  • Planning.
  • Notification.
  • Entrance Conference.
  • Auditee Meetings.
  • Audit Program.
  • Scope Meeting.
  • Fieldwork.

What is an audit in medical billing? ›

Medical Billing Audit Defined

The medical billing auditing process reviews the health records that are maintained by health providers, and the medical billing data submitted to payers so that it can identify, monitor and correct inappropriate billing practices.

What triggers an audit in healthcare? ›

Complaints and breach reports: Audits may be initiated if there are complaints, potential HIPAA violations, or data breaches. It is crucial to promptly address and document such incidents. Random selection: Random audits are conducted to ensure widespread compliance across covered entities and business associates.

What triggers Medicare audits? ›

Failure to recertify the plan of care when appropriate. Noncompliance with frequency/duration rules indicated within Local Coverage Decision (LCD) Insufficient documentation. Post-denial modification to documentation.

How to do a medical record audit? ›

How to do it
  1. Step 1: Select a topic. ...
  2. Step 2: Identify measures. ...
  3. Step 3: Identify the patient population. ...
  4. Step 4: Determine sample size. ...
  5. Step 5: Create audit tools. ...
  6. Step 6: Collect data. ...
  7. Step 7: Summarize results. ...
  8. Step 8: Analyze and apply results.

How do you audit expense claims? ›

An audit process must check all the following aspects:
  1. Confirm compliance. Check whether expenses follow internal company policies - The type of expense, the amount permitted, nature of the expense, etc.
  2. Match reports. Verify whether expense reports match with the company ledger.
  3. Verify documentation. ...
  4. Ensure clarity.

What do auditors look for on an invoice? ›

The audit process usually involves inspecting supplier invoices and comparing the data to the financial records to ensure that the invoices are valid and that only the invoiced amount was paid.

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