Medical Billing Audit Services
UMBS offers professional medical billing audit services for healthcare providers. Our skilled team ensures billing practices meet industry standards.
UMBS Medical Billing Auditing Services
What are Medical Billing Audits?
Medical billing audits check if billing claims and paperwork follow the rules. Certified auditors review patient records to confirm correct coding. Like health check-ups, audits find billing problems early, allowing quick fixes.
Audits help identify issues like incorrect coding, missing documents, and billing rule violations. This proactive approach boosts your revenue cycle, reducing claim denials and penalties. Regular audits ensure accurate coding, complete records, fair payments, and overall financial health.
Get a Medical Billing solution
Check our Medical Billing Audit Solutions
Medical Coding Audit
We review all records, including inpatient, outpatient, profiles, and home health.
Medical Billing Audit
Our audits cover Medicare, Medicaid, commercial, and self-pay claims.
Government & Payor Mandated Audit
We assist with audits from government agencies and payers.
Clinical Audits
Our audits check the quality and safety of patient care.
Collection Aging Audit
We assess collections to improve cash flow.
Auditing Medicare Patient Charts
We ensure compliance and secure fair payments for Medicare patients.
Audit Solutions
Your Billing Challenges, Our Auditing Solutions
Poor billing and coding practices can hurt your medical practice’s finances, leading to lost revenue and potential audits. Our audit services pinpoint areas needing improvement.
We conduct a thorough examination of your staff, processes, and technology, offering tailored recommendations to improve compliance and streamline your revenue cycle. As a top-rated medical billing audit company, we focus on enhancing your practice’s financial health.
Benefits of Our Auditing Services
- Clean Billing Claims: Our audits ensure accuracy in each claim, maximizing reimbursements.
- Correcting Coding Errors: We tackle issues that cause claim denials and revenue loss.
- High Claim Acceptance Rate: We use advanced technology to find coding mistakes, optimizing reimbursements.
- Avoiding Compliance Issues: We help prevent penalties and audits by ensuring billing rules are followed.
- Protecting Against Reimbursement Cuts: Our audit system finds missed revenue and compliance risks.
Streamlined Auditing Processes
Internal Audit
We enhance your internal processes to meet industry standards.
External Audit
Our team resolves disputes and recovers underpayments.
Prospective Audit
We review claims for accuracy and compliance to prevent denials
Retrospective Audit
We analyze claims to correct errors and appeal denials.
Comprehensive Audit
A full audit covering coding, billing, documentation, and compliance.
Missing Money? We'll Find It.
Our specialized audits recover missed revenue and incorrect payments from your billing records.
Our Coding Audit Service Promises Billing Compliance
Auditing your coding accuracy
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.
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
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.
Performing audits of provider-payor contracts
Some other areas we examine are proper application of insurance payor contracts and fee schedules as well as accuracy of data entered into the billing system. Invalid fee schedules and data entry errors can sabotage reimbursement. We verify compliance with payer contracts and recommend process improvements to enhance billing system accuracy. Our comprehensive audits cover all key facets to maximize claim quality and revenue integrity.
Our Help Support
How UMBS Can Help
UMBS specializes in professional medical billing audit services. Given the complexity of medical billing, careful oversight is vital to avoid mistakes. Our auditing services ensure the integrity of your billing processes.
Our experienced auditors examine documentation, coding choices, and submitted claims to find inaccuracies, improving your billing cycle. Our insights guide healthcare facilities toward error-free coding and maximum revenue capture.
By using our high-quality medical billing audit program, you can prevent billing compliance violations and fraud, avoiding fines and reputational damage. Our services are essential for clinical, financial, and regulatory succes
Find Out What a 100%
Medical Claim Audit Can Do for Your Plan
Our Medical Billing Audit Can Help
Identify areas of coding
Protect against fraudulent billing
Prevention of outdated procedure codes
Frequently Asked Questions (FAQs)
A medical billing audit is a review of billing claims and documentation to ensure compliance with industry standards. It helps identify issues like incorrect coding and missing documentation, allowing for prompt corrections.
Medical billing audits are essential for detecting billing errors early. They ensure accurate coding, compliance with payer policies, and optimal reimbursement, helping to improve the financial health of healthcare practices.
We offer various audits, including:
- Medical coding audits
- Medical billing audits for Medicare, Medicaid, and commercial claims
- Government and payer mandated audits
- Clinical audits for patient care quality
- Collection aging audits
It’s recommended to conduct audits regularly—ideally, at least once a year—to ensure compliance and identify areas for improvement. Frequent audits help maintain high standards in billing practices.
Conducting a medical billing audit helps:
- Identify and correct coding errors
- Maximize reimbursements
- Reduce claim denials and penalties
- Improve cash flow
- Ensure compliance with regulations
Our audit services analyze your billing processes, identify inefficiencies, and provide tailored recommendations. This helps streamline operations, reduce errors, and enhance revenue capture.
If compliance issues are identified, we work with your team to address them promptly. Our goal is to correct the problems and implement strategies to prevent future occurrences.
We adhere to strict confidentiality and data protection protocols. All patient information is handled with care and in compliance with HIPAA regulations to ensure privacy and security.
Yes, we assist healthcare providers with government audits, including those from agencies like TPE, RAC, and OIG. We provide support and guidance to help navigate the audit process.
To get started, contact us through our website or call our office. We will schedule a consultation to discuss your needs and how our services can help improve your billing processes.
Our Coding Audit Service Promises Billing Compliance
