MEDICAL BILLING & CODING AUDIT SERVICES
UMBS provides coding and compliance audit services for healthcare providers
UMBS Medical Audit Services
What are Medical Billing Audits?
Medical billing and coding audits ensure provider billing claims and documentation meet compliance standards. Certified auditors review patient charts and records, verifying accurate code usage. Similar to early health screenings, audits detect billing issues early, allowing prompt correction.
Audits are crucial for identifying improper coding, incomplete documentation, missed charges, and reimbursement guideline violations. This proactive approach strengthens revenue cycles, preventing claim denials or penalties. Regular audits ensure accurate coding, complete records, optimal reimbursement, compliance with payer policies, and financial health.
Get a Medical Billing solution
Check our Medical Billing Audit Solutions
Medical Coding Audit
We audit medical coding for all records: inpatient, outpatient, profile, and home health.
Medical Billing Audit
We audit medical billing for Medicare, Medicaid, commercial, and self-pay claims.
Government & Payor Mandated Audit
We assist providers with government and payor audits, including TPE, RAC, OIG, DMEPOS, and Medical Necessity.
Clinical Audits
We conduct clinical audits to evaluate the quality and safety of patient care and outcomes.
Collection Aging Audit
We conduct clinical audits to evaluate the quality and safety of patient care and outcomes.
Auditing Medicare Patient Charts
We audit Medicare charts to ensure billing compliance and full, fair payment for your practice.
Audit Solutions
Your Billing Challenges, Our Auditing Solutions
Clean Billing Claims
Coding Errors
99% Claim Acceptance
Compliance Issues
Meet Billing Compliance
Reimbursement Cuts
Maximum Reimbursements
We streamline your medical billing and coding procedures
Internal Audit
We review and enhance your processes to meet industry standards.
External Audit
We assess claims and payments, resolving disputes and recovering underpayments.
Prospective Audit
We review claims to ensure accuracy, completeness, and compliance, preventing denials, rejections, or reimbursement delays.
Retrospective Audit
We analyze processed claims, correcting errors, appealing denials, and optimizing your revenue cycle.
Comprehensive Audit
We offer a comprehensive audit of your medical practice, covering coding, billing, documentation, and compliance.
Missing Money? We'll Find It.
Our specialized audits recover missed revenue and improper payments from your claims data and 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 does UMBS Medical Coding Audit Company help?
UMBS specializes in professional medical billing audit services. Given the complexity of medical billing and coding, meticulous oversight is essential to avoid errors. Our medical coding audit and compliance services act as a safety net, ensuring the integrity of the entire billing process.
Our experienced billing auditors meticulously examine documentation, coding choices, and submitted claims to uncover inaccuracies and enhance the billing cycle. Our insights guide healthcare facilities toward error-free coding and optimal revenue capture.
Furthermore, our high-quality medical billing audit program prevents billing compliance violations and fraud, averting fines, penalties, and reputational damage. Thus, our audit service serves as a cornerstone of clinical, financial, and regulatory excellence.
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
Our Coding Audit Service Promises Billing Compliance
