In healthcare, the accuracy of medical records holds critical importance. A medical billing audit is performed to ensure coding accuracy, procedures, and policies. The audit is highly extensive because it has to cover every process in the healthcare billing cycle. Some of the processes that it covers include eligibility verification, AR & denial management, payment posting, etc. Through the audit, we evaluate billing records for identifying areas where we need to improve.
What Issues Can We Uncover with Healthcare Billing Audit?
With a healthcare billing audit, we can identify many areas or issues that we need to focus on. With a thorough audit, we can highlight issues, such as:
- Provider Documentation Errors
- Inappropriate or Wrong Codes, Deleted Codes Utilization, and Occurrence of Errors
- Over-coding, Under-coding, Modifier, and Unbundling Use Concerns
- Non-Compliance Areas
- Payer Reimbursement Problems
- Claim Scrubber System Errors
- Intentional or Unintentional Fraudulent Medical Billing Practices
Through these audits, medical practices can avoid heavy penalties due to late claim submission and fraudulent billing issues.
Steps Involved in Healthcare Billing Audit
It is essential to know how the audit process completes. You should remember that audits can be different for different practices. Here are the simple steps involved in the audit process of healthcare billing:
- Determining the audit scope
- Identifying the time for pulling audit samples
- Pinpointing the concern areas
- Taking corrective action
During the audit, it is essential to focus on some key points. You must identify potential and existing problems. It is essential to scrutinize the problems found and act accordingly. Moreover, it is also critical to monitor and track trends and data through regular audits. You must not forget to write you’re your findings in your report.
It is important to revise procedures and policies for preventing problems from recurring. Fast Billing Solutions has a team of specialized billing audit experts with years of experience in the industry. You can count on us for conducting a thorough audit.
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