There are many reasons to perform medical billing audits. Sometimes, insurers or other agencies may perform audits on the actions of health care providers. Most of the time, though, the most productive medical billing audits are the ones that health care providers perform on themselves. Auditing can uncover mistakes that can lead to fraudulent medical claims and inaccurate medical billing activity. Finding these errors will allow health care providers to correct ineffective practices and identify more opportunities for reimbursement.
Are you in need of a medical billing audit in Texas? Whether you’re based in the Lone Star State or elsewhere, it may be most efficient to consider leaving these services in the hands of professional medical billing companies, such as CodeMax Medical Billing. Learn more about the medical billing audit services available at CodeMax Medical Billing by calling us at 866.471.3267 or filling out our online contact form.
What Is the Purpose of Medical Billing Audit Services?
The purpose of medical billing audit services is to uncover mistakes and errors health care providers could be making when filing medical claims and receiving reimbursements.
How does a medical billing audit do this? The organized process examines and reviews involved documents to ensure their accuracy and reliability. It challenges the effectiveness of detailed documentation of the medical billing practice when it thoroughly checks all health records and medical billing data submitted.
The medical billing audit will comb through all present records to identify and correct any medical billing practices that are:
This type of audit can catch potential compliance issues that could eventually impact health care provider bottom lines. Some of these issues may also result in penalties with Medicare if the health care provider involved is credentialed.
What Happens When You Don’t Use Medical Billing Audit Services?
Conducting regular medical billing audits can be beneficial for all health care providers. If you don’t take the time to do these audits, your reimbursements and overall profitability may not be as high as they’d normally be. For instance, conducting an audit on medical record documentation can find services provided to a patient that weren’t officially recorded as charges. A coding and billing audit may also discover that your staff frequently uses incorrect codes. Audits find the inefficiencies in your system and allow you to fix them and increase your profits.
Medical billing audit services can also protect your practice against fraudulent claims and compliance issues. If you’re providing services through Medicare, the latter is increasingly important. Medicare payments depend on accurate submissions. If your practice isn’t documenting and submitting claims with the correct quality measures, you could be subject to fines that will cost your practice money. Audits can not only find ways to increase profits but also ways to avoid expensive fees for Medicare reporting mistakes.
In-House or Outsourced Billing Audit Services: Which Is More Effective?
When it comes to medical billing audit services in Texas or elsewhere, turning to a professional company to outsource the work is the typical choice. Having experts that are not otherwise affiliated with your practice do the audit cuts down on unnecessary professional conflicts.
Medical practices should expect every aspect of their operations to be scrutinized — from their treatment policies to their billing and coding accuracy. Their patients benefit from the quality of their treatments and services and the quality of their customer service, which medical billing affects.
To lessen the odds of triggering a billing and coding audit, you can consider hiring a medical billing company to handle the documents and practices that are typically audited. An experienced firm can manage all of your medical claims and help you spot and fix audit-inducing issues before they affect your bottom line.
Choose CodeMax Medical Billing for a Medical Billing Audit in Texas
If you’re looking for a professional medical billing audit in Texas, contact CodeMax Medical Billing today by completing our online form or calling 866.471.3267. Our team is ready to streamline your practice’s medical billing, so reach out today.