You work hard to provide quality care to your patients, but are you getting paid what you deserve? Errors in medical billing means lost revenue, denied claims, and legal troubles. Therefore, medical billing audit services by a medical coding audit company become a necessity.
UB Billing offers healthcare coding and compliance audit services for healthcare providers. Our experienced billing auditors review a provider’s billing codes for accuracy, compliance, and optimization with real-time issue resolution. So don’t put your practice at risk. Get in touch with us today and let us help you meet medical billing compliance.
Medical billing and coding audits are necessary checkups to ensure a provider’s billing claims and coding documentation meet medical billing compliance. Certified billing auditors inspect patient charts and billing records to guarantee the use of correct codes that match conditions and care. Like routine physicals catching health problems early, audits diagnose issues in billing, allowing providers to correct course.
Audits are important as they reveal improper coding, incomplete documentation, missed charges, and noncompliance with reimbursement guidelines. This helps strengthen a provider’s revenue cycle by correcting errors proactively before they can lead to denied claims or penalties for incorrect billing. Regular comprehensive audits are advantageous as they ensure proper coding, completeness of records, optimal reimbursement, compliance with payer policies, and overall financial health.
UB Billing works as a professional medical billing audit services company. Medical billing and coding is complex work full of pitfalls for error, calling for vigilant oversight. Therefore, our medical coding audit and compliance services provide this monitoring, serving as a safety net that preserves the integrity of the entire medical claims billing process.
The experienced billing auditors at UB Billing, take a magnifying glass to documentation, coding choices, and the submitted claims to unveil inaccuracies and illuminate opportunities for billing cycle improvement. Our findings steer healthcare facilities toward error-free medical coding and full revenue capture.
Just as crucial, our high quality medical billing audit program heads off billing compliance violations and fraud that lead to fines, penalties and damaged integrity. Our audit service is thus a fundamental pillar upholding clinical, financial, and regulatory excellence.
We do medical coding audits for all types of medical records, including inpatient, outpatient, profee, and home health.
We do medical billing audits for all types of claims, including Medicare, Medicaid, commercial, and self-pay.
We prepare providers for and respond to government and payor mandated audits, such as TPE, RAC, OIG, DMEPOS, and Medical Necessity.
We conduct internal and external clinical audits to assess the quality and safety of your patient care and clinical outcomes.
We improve your cash flow by auditing your aged claims for errors and refiling denied claims with our collection aging audit.
We audit Medicare patient charts, ensuring every dollar billed is justified and compliant, so your practice gets fully and fairly paid.
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We conduct an in-depth review of your internal processes and documentation to ensure that they meet the industry standards. We also provide recommendations to help providers improve their performance.
We perform an independent assessment of your claims and payments from third-party payers like Medicare and Medicaid. We resolve billing disputes, recover underpayments, and work with aged receivables.
We evaluate your claims before they are submitted to the payers, to ensure that they are accurate, complete, and compliant. We help you prevent any denials, rejections, or delays in reimbursement.
We analyze your claims after they have been processed by the payers, to identify any errors. We help you correct any mistakes, appeal any denials, and optimize your revenue cycle.
We provide a holistic approach to auditing your entire medical practice. We examine all aspects of your operations, from coding and billing to documentation and compliance.
Our specialized audits dig deep into your claims data and billing records to recover improper payments and missed revenue.
Assessing coding accuracy is a principal objective of our medical coding audit company. We thoroughly investigate medical charts to ensure codes mirror the diagnosis, completed procedures, and complexity level. Proper coding is vital for correct reimbursement and adherence to guidelines. Our audits identify any upcoding or undercoding issues and recommend remedial actions. With our assistance, doctors can have confidence their coding satisfies standards and captures the total value due.
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.
Thorough documentation review is also part of our billing audit process. We assess whether the medical record provides clear, consistent documentation that supports the coded claims. Complete, accurate documentation is required to justify charges and pass payer scrutiny. Our team flags any documentation issues like vagueness, inconsistency, missing signatures/credentials, or lack of medical necessity. We provide guidance to strengthen documentation practices for better claim defense and audit survival.
Thorough documentation review is also part of our billing audit process. We assess whether the medical record provides clear, consistent documentation that supports the coded claims. Complete, accurate documentation is required to justify charges and pass payer scrutiny. Our team flags any documentation issues like vagueness, inconsistency, missing signatures/credentials, or lack of medical necessity. We provide guidance to strengthen documentation practices for better claim defense and audit survival.
We provide in-depth reporting to give you a complete picture of your coding and billing operations. Here are some of the most important reports that you can request post-auditing:
This report analyzes your charge capture process to identify areas of revenue leakage. We examine front-end charge capture issues that lead to missed charges and lost revenue. The report provides specific recommendations to improve charge capture.
Our coding audit examines a sample of charts to identify coding errors and improvement opportunities. The audit report details coding accuracy rates, the financial impact of errors, and targeted education needs for coders. We also provide a risk analysis to help prioritize auditing efforts.
By analyzing your denials data, we identify the leading denial reasons, whether appeals are warranted, and opportunities to prevent future denials. Our denial report provides the information you need to reduce denials and improve revenue cycle performance.
This assessment gauges your compliance risk levels in areas such as coding and billing documentation, Medicare regulations, and HIPAA. We provide a scorecard measuring your risk exposure and a roadmap for strengthening your compliance program.
How do your KPIs stack up? Our benchmarking report compares your metrics to industry averages so you can pinpoint areas for improvement. We examine leading indicators such as first-pass resolution, net collection rate, A/R days, and more.