Medical Audit
Description
Providing quality care is your priority, but are you receiving the payments you deserve? Billing errors can lead to lost revenue, denied claims, and compliance risks. That’s why a thorough medical billing audit is essential.
At MediClamz, we offer expert healthcare coding and compliance audit services tailored for healthcare providers. Our skilled auditors meticulously review billing codes for accuracy, compliance, and optimization, ensuring real-time issue resolution. Don’t leave your practice vulnerable—contact us today for reliable medical billing compliance support!
What Are Medical Billing Audits?
Medical billing and coding audits serve as essential checkups to ensure billing claims and documentation comply with industry regulations. Certified auditors review patient records and billing data to verify accurate coding that aligns with diagnoses and treatments. Just like routine health checkups detect potential issues early, audits help identify and correct billing errors before they lead to denied claims or compliance risks.
These audits play a crucial role in detecting improper coding, incomplete documentation, missed charges, and noncompliance with reimbursement guidelines. By addressing these issues proactively, healthcare providers can strengthen their revenue cycle, reduce claim denials, and avoid penalties. Regular audits ensure accurate coding, complete records, optimal reimbursements, and adherence to payer policies, ultimately safeguarding financial health.
How Does MediClamz Medical Coding Audit Company Help?
MediClamz is a trusted provider of professional medical billing audit services, ensuring accuracy and compliance in the complex world of medical billing and coding. Our audit and compliance services act as a safety net, preserving the integrity of the entire claims process.
Our expert auditors meticulously review documentation, coding selections, and submitted claims to identify errors and uncover opportunities for revenue cycle optimization. By addressing inaccuracies, we help healthcare providers achieve error-free coding and maximize reimbursements.
Beyond financial benefits, our comprehensive audit program proactively prevents compliance violations, fraud, and penalties, safeguarding both a practice’s revenue and reputation. With MediClamz, healthcare facilities uphold clinical, financial, and regulatory excellence.
Other Services
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Partner with MediClaimz for seamless claim processing, faster reimbursements, and optimized revenue cycle management.
MediClamz Consultancy Features
Why Choose MediClamz Billing Consultation?
Medical Coding Audit
We conduct coding audits for all medical records, including inpatient, outpatient, professional, and home health.
Medical Billing Audit
We perform audits for all claim types, including Medicare, Medicaid, commercial, and self-pay, ensuring accuracy in medical billing.
Govt. & Payor-Required Audit
We help providers prepare for and respond to government/payor audits like TPE, RAC, OIG, DMEPOS, and Medical Necessity.
Clinical Audits
We perform internal and external clinical audits to evaluate patient care quality and clinical outcomes.
Collection Aging Audit
We enhance cash flow by auditing aged claims for errors and refiling denied claims through our collection aging audit.
Medicare Patient Chart Auditing
We audit Medicare patient charts to ensure billing accuracy and compliance, ensuring your practice is fully and fairly reimbursed.
Appointment
Schedule Your Care with Our Certified Experts
Work Hours
Available Monday to Saturday for reliable medical billing support.
Audit Solutions
Your Billing Issues, Our Auditing Solutions
Inaccurate billing and coding can be costly for medical practices. Denied claims result in lost revenue, while backlogs cause cash flow issues. Errors lead to audits and penalties. Our billing and coding audit service identifies weaknesses in your workflows. After analyzing your people, processes, and technology, we provide targeted recommendations to ensure compliance and improve your revenue cycle.
Billing Errors
Affect the financial stability, cash flow, profitability, and sustainability of the healthcare organization.
Clean Billing Claims
With our comprehensive billing audit, we thoroughly examine each claim to verify correctness, securing maximum appropriate reimbursement to maintain financial health and endurance of your healthcare institution.
Coding Errors
Lead to claim denials, loss of revenue, overcharges, underpayments, patient dissatisfaction, and legal actions.
99% Claim Acceptance
We deploy advanced NLP and machine learning techniques to analyze medical records and catch coding mistakes, optimizing reimbursement and circumventing claim denials down the line.
Compliance Issues
Result in penalties, fines, audits, investigations, lawsuits, sanctions, and exclusion from federal health programs.
Meet Billing Compliance
Our robust billing analytics engine identifies trends, outliers and red flags in real-time, allowing for targeted audits to eliminate compliance risks and avoid government scrutiny.
Reimbursement Cuts
Could force healthcare providers to reduce staff, limit services, close practices, or accept fewer Medicare patients.
Maximum Reimbursements
Our proprietary AI-powered billing audit system analyzes your claims data to identify missed revenue opportunities and compliance risks, ensuring every penny is captured before reimbursement cuts hit your bottom line.
MediClamz Consultancy Features
We Optimize Your Medical Billing and Coding Processes
Internal Audit
We conduct an in-depth review of your internal processes and documentation to ensure that they meet the industry standards. We also provide recommendations to help providers improve their performance.
External Audit
We perform an independent assessment of your claims and payments from third-party payers like Medicare and Medicaid. We resolve billing disputes, recover underpayments, and work with aged receivables.
Prospective Audit
We evaluate your claims before they are submitted to the payers, to ensure that they are accurate, complete, and compliant. We help you prevent any denials, rejections, or delays in reimbursement.
Retrospective Audit
We analyze your claims after they have been processed by the payers, to identify any errors. We help you correct any mistakes, appeal any denials, and optimize your revenue cycle.
Comprehensive Audit
We provide a holistic approach to auditing your entire medical practice. We examine all aspects of your operations, from coding and billing to documentation and compliance.
Missing Money? We'll Find It.
Our specialized audits dig deep into your claims data and billing records to recover improper payments and missed revenue.
Providers
Performed
Why Mediclaimz?
Our Coding Audit Service Promises Billing Compliance
Auditing your coding accuracy
Our audits ensure coding accuracy, aligning with diagnoses and procedures to guarantee proper reimbursement and compliance. Select 84 more words to run Humanizer.
Improving your charge capture accuracy
We review charge capture to ensure all services and supplies are billed at correct rates, identifying missed charges to maximize reimbursement.
Billing Documentation Compliance Audit
Our billing audit includes a thorough documentation review, identifying issues like vagueness or missing signatures, and providing guidance for improvement.
Auditing Provider-Payor Contracts
We audit provider-payor contracts, ensuring accurate fee schedules and data entry to improve reimbursement and billing system accuracy.
MediClamz Consultancy Features
We Optimize Your Medical Billing and Coding Processes
Get Post-Audit Reports Delivered Straight Into Your Inbox
We conduct an in-depth review of your internal processes and documentation to ensure that they meet the industry standards. We also provide recommendations to help providers improve their performance.
Charge Capture Analysis Report
This report analyzes your charge capture process to identify areas of revenue leakage. We examine front-end charge capture issues that lead to missed charges and lost revenue. The report provides specific recommendations to improve charge capture.
Coding Audit Report
Our coding audit examines a sample of charts to identify coding errors and improvement opportunities. The audit report details coding accuracy rates, the financial impact of errors, and targeted education needs for coders. We also provide a risk analysis to help prioritize auditing efforts.
Denials Analysis Report
By analyzing your denials data, we identify the leading denial reasons, whether appeals are warranted, and opportunities to prevent future denials. Our denial report provides the information you need to reduce denials and improve revenue cycle performance.
Compliance Risk Assessment Report
This assessment gauges your compliance risk levels in areas such as coding and billing documentation, Medicare regulations, and HIPAA. We provide a scorecard measuring your risk exposure and a roadmap for strengthening your compliance program.
Revenue Cycle Performance Benchmarking Report
How do your KPIs stack up? Our benchmarking report compares your metrics to industry averages so you can pinpoint areas for improvement. We examine leading indicators such as first-pass resolution, net collection rate, A/R days, and more.
Enhance Your Data Quality and Compliance
Medical Chart Reviews and Validations
Our clinical auditors performs various types of medical chart reviews, such as inpatient, outpatient, radiology, DME audit, mammography audit, etc. We assess the quality of the care provided, the compliance with the coding and documentation standards, and the adherence to the clinical guidelines.
We can verify the accuracy of your risk adjustment data, such as diagnosis codes, hierarchical condition categories (HCCs), and risk scores. This can help you optimize your reimbursement, avoid penalties, and improve patient outcomes.
We extract and abstract relevant data from your medial charts, such as diagnosis, procedures, medications, lab results, and quality measures. We also verify the accuracy of data entry in your EHR or other systems.
We review your charge capture process to ensure the charges billed to the payers are accurate and supported by the documentation in the medical chart. We also identify and resolve any undercharges or overcharges that may affect your revenue cycle.
Start Your Journey to Stress-Free Medical Billing!
Partner with MediClaimz for seamless claim processing, faster reimbursements, and optimized revenue cycle management.