Billing Integrity Audits

Our Billing Integrity Audits help to ensure compliance and that your practice is capturing charges accurately and being reimbursed properly for its services. There are several layers to this kind of audit, and we can provide an audit of your entire system or just the areas of concern, depending upon your specific needs. Every practice needs to confirm they are billing correctly and compliantly – both for clinical reasons and reimbursement reasons. Our team can take a selection of charts per payor and per provider and thoroughly audit  each chart to confirm the proper documentation, correct coding, and appropriate billing levels were submitted on each claim.

• We review documentation, billing and coding to ensure your practice received the maximum reimbursement allowed, based on the clinical documentation. We identify any gaps with modifiers, CPT codes or diagnosis codes, particularly with ICD-10, and ensure the appropriate billing levels were submitted with each claim.
• We then assess where there are deficiencies or areas of concern and provide you with an action plan to resolve concerns. Assisting you in implementing the action plan is a service that is also available to you through our Medical Billing Services. We also look at potential underpayments, overpayments, fee schedule discrepancies, EOB Reviews and provide ICD-10 training, depending upon your needs.