Is your medical practice ready to face a medical billing audit? Health care providers should always know how to prepare for an audit, if only because audits improve revenues and decrease fees you may have to pay. Even if your medical billing services haven’t caught any recent spikes in denials or collection problems, an audit may still be needed. In an industry where profit margins can be razor-thin, medical practices must collect every dollar they’ve earned. But if you don’t periodically conduct medical billing audits, you’re almost certainly not operating at your optimal performance level.
In order to identify weaknesses and shore up potential risks, a medical billing audit could be needed. At CodeMax Medical Billing, we can teach you how to prepare for a medical billing audit and how your practice can benefit from one. If your health care facility is looking to outsource medical billing services, contact our team today by calling 866.471.3267 or completing our online form.
What Is a Medical Billing Audit?
A medical billing audit is an organized process meant to examine and review medical billing documents to ensure accuracy. It investigates the reliability and effectiveness of detailed billing documentation of medical practices, including checking all health records and medical billing data submitted by the payers.
The medical billing audit process will comb through all stored data and records to identify, monitor, and correct any inaccurate, incomplete, or inappropriate billing practices. Audits can catch potential compliance issues that eventually could land you penalties with Medicare or impact your practice’s bottom line.
How Do Medical Billing Audits Help Health Care Providers?
Conducting regular medical billing audits is beneficial, no matter what the motivation for doing them may be. Although medical billing audits are initially compliance measures meant to check that you’re managing a compliant operation, they can also be methods to find inefficiencies that are costing your health care facility money. For instance, conducting a medical billing audit can point to services or items provided to patients that weren’t recorded as charges. Improving medical record documentation can lead to increased payments for services provided.
A medical billing audit can also protect your health care facility against compliance issues and fraudulent claims. If you’re providing services through Medicare, this is essential. Medicare payments are dependent on accurate submittals. If you’re not documenting and submitting the correct information, you could be subject to multiple penalties.
Medical billing audits can help find ways to increase profits and avoid expensive fees for mistakes with Medicare reporting.
Preparing for an Audit: What Can Health Care Providers Do?
Every single audit is time-consuming and typically disrupts normal business activities. However, audits are necessary time sinks, as they provide transparency, build and maintain stakeholder trust, and address third-party security and privacy concerns.
To always be prepared for a medical billing audit, you can document all procedures, enforce security requirements, and understand your systems and data flow properly. To prepare for an upcoming one, you should examine the results of your last audit, and deal with any problems it may have pointed out. After that, you can:
- Ensure you have an audit trail. Document everything because to regulators, an event or action didn’t happen if there’s no documentation.
- Assemble the pieces of the audit’s focus. This can include documentation on backup schedules, software updates, organization structure, asset inventory, and access logs of both physical and sensitive data.
- Decide how and when you are going to fix issues brought up by the medical billing audit. Typically, a period of four to six weeks after the audit is enough time to remediate.
Keep in mind that audits happen all the time. It’s advisable to make the audit prep process part of your ongoing compliance program. Most certifications require you to demonstrate regularly that your medical billing processes are at a high-performance level.
Partner with CodeMax Medical Billing to Prepare for Billing Audits
If your health care facility having trouble outsourcing medical billing services, including internal auditing, contact CodeMax Medical Billing today by calling 866.471.3267 or completing our online form. Our team of experts can help you prepare for an audit, so reach out to us today.