Medical billing and coding services are critical to any medical practice’s success. Medical practices may face financial instability if the process does not follow the most recent guidelines. Medical billing auditing should be explored by healthcare businesses in order to ensure efficient revenue cycle management (RCM) and lower accounts receivable (AR).

Many healthcare companies were compelled to take a prolonged, hard look at their claim processing methods as a result of the shift to ICD-10. The significance of auditing in healthcare businesses has not diminished while that transition comes to an end. Every practice should have a clear insight on what kinds of billing audits the best suit to their specific business requirements.

What is a Medical Billing Audit

A medical billing audit is a systematic examination and evaluation of documentation to ensure its accuracy. The procedure looks into the accuracy and efficacy of the practice’s comprehensive documentation, which includes double-checking all health records and medical billing data provided by payers. It’s a method for identifying problematic areas in clinical documentation of services provided. The focus is to enhance the revenue cycle by addressing these concerns.

The medical billing process will scour through all current data and records in order to detect, monitor, and rectify any billing practices that are erroneous, incomplete, or improper. Audits might uncover significant compliance flaws that could have a negative impact on your bottom line or result in Medicare penalties if you’re credentialed.

What are the Benefits of Medical Billing Audit

• Improved Coding Accuracy

Billing audits are beneficial to coding personnel because they allow them to discover and resolve significant issues before the government or insurance payers raise concerns related to improper coding. Conducting a medical billing audit facilitates and accelerates the claim compilation and submission processes with improved billing and coding processes.

• Smarter Administrative Process

Medical billing audits benefit the administrative workforce by ensuring that claims are valid and accurate, and that they are filed appropriately. The practice is protected from fraudulent billing and claims through medical claims audits. Practices may effectively verify compliance with ICD-10-CM and EHR Meaningful Use readiness when they have an internal check and balance system in place. Payment errors are decreased or eliminated by implementing medical billing audits.   Additionally, the practice is benefitted when files are processed quickly, improper payments are reduced, and claim payment is optimized.

• Clinical Benefits

Medical claims audits enhance patient care in a pleasant manner. The focus of the entire practice turns to the quality of care offered through tracking and monitoring services and procedures, as well as training physicians on how to provide contented medical experiences to their patients. When medical billing and claims processing workflow is streamlined, you can run your business more efficiently and dedicate more time to your patients. When patients have a better experience, the revenue cycle runs more smoothly, and patients have enhanced patient outcomes.

Wrapping Up

As billing gets increasingly complex, every medical practice will need to take a deliberate, strategic approach to billing and coding audits. Medical billing audits help to mitigate flaws and provide reliable revenue cycle management, even if your medical billing and coding systems are working perfectly. To obtain a more significant ROI in their auditing investment, businesses should integrate their healthcare audit arsenal with proficient professionals for a smooth medical billing audit process.