Ensure Accurate Billing and Coding for Maximum Reimbursement

Q: What is a Billing Integrity Audit?

A Billing Integrity Audit is a comprehensive review of your practice's billing, coding, and documentation processes to ensure compliance, accuracy, and proper reimbursement.

Q: Why is a Billing Integrity Audit important?

Audits help identify and correct billing errors, prevent compliance risks, and ensure you receive the maximum reimbursement for services rendered.

Q: How often should a practice conduct a Billing Integrity Audit?

We recommend conducting an audit at least annually or whenever significant changes in billing regulations occur.

Q: What payors do you review during the audit?

We audit billing processes for all major payors, including Medicare, BCBS, Medicaid, and private insurance companies.

Q: Can you audit a specific area of concern instead of the entire billing system?

Yes, we customize our audits to focus on your specific needs, whether it’s underpayments, modifier usage, or CPT code accuracy.

Q: What happens if errors are found during the audit?

We provide a detailed report outlining deficiencies and recommendations, along with an action plan to correct errors and enhance compliance.

Q: Does the audit help identify overpayments or underpayments?

Yes, our audit includes a review of potential overpayments, underpayments, and fee schedule discrepancies to ensure accurate reimbursement.

Q: Do you offer training or implementation support after the audit?

Yes, we provide ICD-10 training and implementation assistance through our Medical Billing Services.

Q: How long does a Billing Integrity Audit take?

The timeline varies based on the size of the practice and the scope of the audit, but most audits are completed within a few weeks.

Q: How can we schedule a Billing Integrity Audit?

You can contact our team to discuss your needs and schedule an audit at a convenient time for your practice.

Protect Your Practice. Recover Lost Revenue. Stay Audit-Ready.

Stop leaving money on the table! Ensure every charge is captured and billed correctly, while safeguarding your practice from audits.

Medical billing errors can lead to lost revenue, compliance issues, and increased scrutiny from payors like Medicare and BCBS. Our Billing Integrity Audits ensure that your practice captures all charges accurately, remains compliant, and receives proper reimbursement for services provided.

Comprehensive Billing Audits Tailored to Your Needs

We provide a thorough audit of your entire billing system or focus on specific areas of concern based on your practice's unique needs. Our expert team conducts detailed billing and coding reviews or audits per payor and per provider to ensure proper documentation, correct coding, and appropriate billing levels for each claim.

Billing errors are more common than most practices realize-and they can cost you thousands in lost revenue and expose your organization to audits and penalties. Our Billing Integrity Audits dive deep into your current processes, claims data, and documentation to identify gaps, recover lost revenue, and strengthen compliance.

What Our Billing Integrity Audits Include:

Charge Capture & Compliance Review

Ensuring all billable services are properly documented and submitted.
Billing & Coding Analysis

Identifying gaps in CPT codes, diagnosis codes (ICD-10), and modifiers.
Reimbursement Maximization

Confirming that your practice receives the highest allowed reimbursement.
Underpayment & Overpayment Identification

Detecting fee schedule discrepancies and potential revenue losses.
EOB Reviews & Claim Assessments

Analyzing Explanation of Benefits (EOBs) for accuracy.
Billing Process Optimization

Strengthening internal billing workflows and compliance efforts.
ICD-10 Training & Compliance Support

Providing education and guidance on proper coding practices.

Actionable Insights and Implementation Support

Following the audit, we deliver a comprehensive action plan that highlights deficiencies and areas for improvement. Our team is available to assist with implementing the recommended changes through our Medical Billing Services, ensuring ongoing compliance and optimized reimbursement.

Why Choose Our Billing Integrity Audits?

Reduce the risk of Medicare Medicaid and BCBS audits

Improve billing accuracy and compliance

Maximize reimbursement with proper coding

Identify and resolve billing errors efficiently

Strengthen internal billing compliance processes

Deep expertise in RCM, compliance, and payor policies

Proven methodology with measurable results

Trusted by private practices, physician groups, and hospitals nationwide

The ROI is Real

Clients report a 15-20% revenue increase after audit implementation

Reduced denials, faster reimbursements, and fewer compliance risks

Immediate insight into billing vulnerabilities before payors find them

Secure. Precise. Profitable.

Don't wait until a payor audit catches you off guard. Our Billing Integrity Audits ensure your revenue is protected, your coding is clean, and your claims are optimized for maximum reimbursement.

Frequently Asked Questions

What is a Billing Integrity Audit?

Why is a Billing Integrity Audit important?

How often should a practice conduct a Billing Integrity Audit?

What payors do you review during the audit?

Can you audit a specific area of concern instead of the entire billing system?

What happens if errors are found during the audit?

Does the audit help identify overpayments or underpayments?

Do you offer training or implementation support after the audit?

How long does a Billing Integrity Audit take?

How can we schedule a Billing Integrity Audit?

What Our Customers Have to Say

We are fast approaching our one-year anniversary, and although I wish circumstances with HFT Counseling had been different, I am truly glad that Legacy Consulting was there for us. Internal flags with our HFT ministry arose in the spring of 2015. In the fall of 2015, we initiated our search for a medical practice audit firm.

The Legacy proposal stood out not only for the skills and expertise offered, but more so for the strong alignment of Christ-centered values between Legacy and Patrick Henry Family Services. Your Legacy team quickly verified our concerns and diligently dug in to completely diagnose the situation; they met with clinicians, staff, and constituents to thoroughly assess the severity of the problem; produced comprehensive reports and analysis; and provided a comprehensive corrective action plan.

Without reservation, The Legacy Consulting Team was outstanding in their work for Patrick Henry Family Services. You were thorough, detailed, professional, and a "friend" when we needed one. The results were outstanding and timely. With Legacy, we have a bright future!

Stephen O. Edwards

COO, Patrick Henry Family Services

Expert, honest, and dedicated team for revenue cycles, billing and coding in health care. Also amazing at the forensic discovery of problems in claims and revenue cycle!

Nancy Thomas

Clinical Network Manager, New Directions Behavioral Health

Featured Resources

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Billing Integrity Audits – How They Help Your Practice Grow

One of the many services Legacy Consulting provides is Billing Integrity Audits. There are several layers to this kind of audit and we can provide all or just some of the pieces, depending on our client’s needs. These audits can prove useful to assure compliance and ensure your practice is being reimbursed properly for its […]

Take Control of Your Billing Integrity Today

Legacy Consulting Services brings decades of healthcare revenue cycle and compliance expertise to every engagement. We don't just audit-we transform your billing operations for long-term profitability and peace of mind.

Take the First Step Toward Revenue Confidence.
Schedule your free billing integrity consultation audit and safeguard your revenue.