Medical billing audits look into every aspect of the medical billing process.
Fremont, CA: An internal medical billing and coding audit is a procedure for examining and evaluating clinical data as well as the entire medical billing process. This procedure carefully verifies the practice's health records and reviews medical billing data given to payors to guarantee that the practice discovers, monitors, and corrects incorrect billing practices.
Clinical records, such as medical records, x-rays, and lab reports; financial records, such as entered charges, explanation of benefits (EOBs), and accounts receivable ledger; and policy-related documentation, as required by providers or the government, are all collected during a coding and billing audit.
Audits can also get performed either before or after claims are sent out to payors (prospective) (retrospective). Some practices follow the guideline of performing prospective new provider audits and retrospective existing provider audits.
Unlike coding audits, medical billing audits take a complete approach. Medical billing audits look into every aspect of the medical billing process, including insurance verification, ICD-10-CM, CPT coding, claim submission, payment posting, follow-up, and rejection management.
Advantages of Medical Billing Audit
Coding compliance
Before the government or insurance payors contest erroneous coding, billing audits give an opportunity to discover and resolve issue regions.
