Reliable Medical Billing Audit Services
Our detailed medical billing audit services identify coding errors, reduce billing inefficiencies, increase claims accuracy, and improve practice profitability.
Our detailed medical billing audit services identify coding errors, reduce billing inefficiencies, increase claims accuracy, and improve practice profitability.
A medical billing audit is a systematic review designed to ensure the accuracy and efficiency of coding and billing processes. Our expert medical billing audit services identify, correct, and monitor billing inefficiencies to prevent revenue loss and maximize reimbursements for higher profitability.
Similarly, a medical billing audit identifies improper coding practices, incomplete documentation, missed charges, and reasons for claims denials. Once these inaccuracies are identified, the errors are corrected and resolved to stay compliant with the industry standards. This helps providers improve their revenue cycle for financial success.
Atlantis RCM is a trusted medical billing company that provides comprehensive medical billing audit services to small and large practices including hospitals, clinics, and individual doctors. For a comprehensive analysis, we go deep down to determine any hidden issues in your billing process that can affect your healthcare revenue in the long run.
Our auditing professionals conduct a thorough audit while focusing on several key performance indicators (KPIs). We cover everything from charge and payment analysis to analyzing unresolved denials, reviewing failed claims, identifying medical coding errors, and determining compliance issues. Ensure you don’t leave money on the table!
We provide a proactive process to review medical claims, coding, and documentation before submission. With this review, we identify and correct potential errors to maximize reimbursements.
Our expert auditors ensure that medical coding complies with guidelines (e.g., CPT, ICD-10, HCPCS). They also verify coding accuracy to avoid errors, upcoding, or under coding.
Through a systematic process, we provide clinical auditing to review medical patient care, documentation, and treatment practices.
Our professionals actively eliminate healthcare fraud by focusing on detecting, preventing, and reducing fraudulent activities in the billing process.
We examine denied claims to identify root causes, resolve issues, and prevent future rejections by insurance payers.
With a systematic review process, we ensure a healthcare organization adheres to federal, state, and industry-specific regulations. This helps avoid penalties and maintain credibility.
Let us make sure nothing stays in the dark!
Claim Free Medical AuditSometimes, your billing process faces various problems including inaccurate billing and coding practices. These issues can cause big revenue loss and penalties. Along with medical billing services, Atlantis RCM delivers timely and accurate solutions to your billing problems to maintain a better revenue cycle. Get our premier audit solutions to your inefficient billing practices and increase your profitability.
It involves using incorrect diagnosis or procedure codes due to errors in CPT, ICD-10, or HCPCS coding. This can lead to claim denials or underpayments.
We use advanced software to provide accurate coding. With this process, we detect and minimize coding errors before claim submission to get high profitability with a 99% clean claims ratio.
Your insurance claims can be denied due to different reasons, including incomplete documentation, incorrect information, or medical coding errors.
Our team conducts a pre-audit review to identify and correct any mistakes in information before claim submission. We also ensure proper documentation to fix recurring issues.
Duplicate billing is a problem that arises due to intentional or unintentional billing of the same claim for different or the same services. It can lead to denials and compliance risks.
To prevent duplicate billing, we have implemented software to detect duplicate claims. We also conduct manual cross-checks of billing practices to minimize duplication errors.
In internal audit, we conduct an in-depth analysis of your documentation and billing practices to ensure they meet the industry standards. We also recommend ways to eliminate errors and maximize revenue.
We perform independent assessments to ensure the accuracy, compliance, and overall efficiency of the billing process for your healthcare organization.
To identify billing errors, non-compliance, and fraud, we randomly check and review medical records to remove any potential issues in the billing process.
Before submitting the claims, our team examines and checks high-risk areas noted in previous audits to find and correct any billing or coding errors.
Once the claims are submitted successfully, we monitor and review them to find and correct errors and issues that can lead to denials. This minimizes errors and reduces the risks of denials.
Ensure error-free claims and maximize reimbursements with our audits. Let us review your billing to recover missed revenue!
Satisfied Clients
Audits Performed
Coding & Billing Errors Fixed
Revenue Recovered
Assessing your medical coding for accuracy is a core principle of our company. We ensure all your medical codes used for procedures and diagnoses are 100% correct. With this, we prevent errors and issues which can lead to claim denials or fraud. Moreover, our team identifies upcoding or undercoding issues and recommends corrective actions.
Staying compliant with evolving medical coding guidelines and regulations can boost your practice revenue. Our medical billing auditors make sure all your billing and coding practices align with healthcare laws such as HIPAA, CMS guidelines, and payer-specific policies.
Proper documentation is necessary to justify charges and pass payer scrutiny. We provide a complete review of the billing records and ensure they follow clear and consistent documentation that can lead to maximum reimbursements and reduced denials. In addition, auditors examine if the documents adequately support the used codes.
Another major element we ensure for billing compliance is staying current with ICD, CPT, and HCPCS updates. This helps us use accurate codes in the billing system. Besides compliance assurance, this also reduces denials by preventing coding errors.
We provide a systematic approach for a detailed examination of your billing practice. To guarantee 100% billing compliance, we provide complete audit solutions that ensure transparency from start to finish. The process goes as follows:
Our audit process starts with collecting and gathering all necessary medical records, codes, billing data, claim submissions, payer contracts, insurance plans, and other related information for thorough analysis and review.
After the data is acquired electronically with a trusted EHR system, we organize and analyze whole documents to identify inconsistencies, missing documentation, compliance gaps, and other inaccuracies that can lead to denials.
This step involves documenting and summarizing the key issues, such as coding errors, missing information, and denied claims with a structured approach to ensure clarity, accuracy, and actionable insights.
Lastly, our final report compiles audit findings, compliance risks, and missing information. It also includes recommendations, corrective actions, and feedback for compliance and improvements. We share the report with healthcare providers to ensure accountability.
Once the billing accuracy check is completed, it is important to implement corrective actions and educate the staff about inappropriate billing practices. Our training equips your team to overcome risks and problems in the billing practice for measurable improvements. Our professional medical billing audit informs and educates you on:
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