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Medical Billing Audits Blog Posts

Medical Auditing Can Help Increase Profitability

Patrick Dougherty

Nearly every medical practice faces auditing from governmental agencies like the CMS. An equally important auditing process, however, is one that your medical practice takes on itself. 

Medical Auditing Explained

The main reason to perform a medical audit is to improve the financial health of your medical practice. An audit evaluates medical codes selected for diagnosis and procedures to ensure that they are supported by documentation from the physician. Any weaknesses revealed identify training opportunities that can be applied to your medical team

Second reason for medical practice owners and administrators to perform an audit is to make sure  deliver the highest quality health care to patients, your medical team must rely on patient health records. Ensuring that this documentation is complete, accurate and clear is the purpose of engaging in a medical audit. It serves to highlight those areas that need to be corrected and/or improved. 

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Topics: Medical Billing Audits, medical billing analysis

6 Critical Tips to Avoid RAC Audits

Patrick Dougherty

Many providers are aware that CMS has increased its Recovery Audit Contractor or RAC audits and commercial payers are also taking a closer look at billing and coding usage. Data analytics usage has enabled payers to identify coding and other “outliers” and in turn, track for audits. With a stated goal of recovering over $2 billion in “improper payments” it’s more critical than ever for practices to be in compliance. While having a good tax preparer on your team can also reduce accounting errors and other red flags, many practices commit documentation and management mistakes that can lead straight to the auditor’s office.

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Topics: RAC Audit, Medical Billing Audits

Tips for Conducting Thorough Medical Billing Audits

Harold Gibson

Both internal and external audits are critical to maintaining the fidelity and compliance of your medical billing processes. However, they need to be conducted thoroughly if they are to be of any value. Medical billing audits ensure that issues are caught ahead of time -- so that there aren't any surprises. Medical billing audits also catch issues such as fraud early on, before they can become a serious issue. 

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Topics: Medical Billing Audits

About this blog

A place for physicians and other healthcare stakeholders to share and discover information about everything related to running efficient medical practices.

Established in 2002 by a group of physicians, we are a national provider of medical billing services to group practices, clinics, and individual physicians. We also specialize in provider credentialing, payer contract reviews, and medical coding for a wide range of clients - from solo practitioners to multi-site, multi-specialty practices.

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