Paperless Coding Solutions
Medical Billing and Coding Audit Services
Ensure compliance, reduce denials, and recover lost revenue with our expert-led medical billing and coding audit services. Certified auditors thoroughly review your codes, claims, and documentation for accuracy, helping you to identify errors before they impact reimbursement. Trust our HIPAA-compliant team to protect your practice, support regulatory compliance, and optimize financial performance.
Why Medical Billing and Coding Audits Matter More Than Ever
In today’s healthcare industry, even minor coding or billing errors can lead to significant revenue loss, denied claims, or payer audits. Many practices make the error of undercoding, overcoding, or submitting claims with mismatched paperwork, putting compliance and payment at risk. Regular audits identify these flaws before they become costly problems.
With changing payer restrictions, increasing CPT®, ICD-10, and HCPCS codes, and more intense documentation standards, staying current is not an option; it must be done. Medical billing and coding audits ensure that your claims fulfill all payer and regulatory criteria, reducing the risk of recoupments, fines, and cash flow delays.
Audits can help to enhance internal procedures by identifying gaps in coding correctness, modifier usage, and provider documentation. Audits, whether you’re a physician, hospital, or telemedicine provider, optimize your revenue cycle and empower your staff to focus on patient care rather than administrative modifications.
What’s Included in Our Healthcare Audit Solutions
Our medical coding audit services are designed to address your organization’s specific coding and billing challenges.
Comprehensive Retrospective Audits
We analyze prior claims (CPT®, HCPCS, and ICD-10 codes) for mistakes, undercoding, overbilling, or modifier use.
Live (Prospective) Coding Audits
We check coding correctness thoroughly before submitting claims, which reduces rejections and helps prevent payer scrutiny.
E/M Leveling & Documentation Reviews
Ensure that provider remarks clearly correspond to the codes billed. We proactively find gaps in paperwork that may result in costly rejections.
Compliance Reviews
Our detailed audits fully comply with CMS, HIPAA, OIG, and payer-specific requirements, significantly reducing the risk of penalties, fees, and overpayment demands.
Revenue Impact Analysis
We highlight potential revenue loss due to inaccurate billing and suggest exact, actionable adjustments that effectively enhance overall bottom-line performance.
Custom Audit Reports + Actionable Feedback
Receive a clear, complete report outlining the findings, including coding insights, documentation advice, and opportunities for provider education.
Who Needs Medical Billing and Coding Audit Services?
Comprehensive Medical Coding Services
Ready to optimize your practice’s revenue and streamline your billing process? Fill out the form to request a free consultation and learn more about our comprehensive medical coding services. Our team of experts is here to answer all your questions and help you take the next step toward financial success.
Sign Up For Medical Billing Services
Schedule a Free Audit Assessment Today
Protect your revenue. Stay compliant. Ensure billing accuracy.
Let our certified billing and coding auditors uncover what’s costing you revenue and fix it before it affects your bottom line.
Common Coding Errors We Catch
Undercoding
Leads to revenue loss by failing to capture the full scope of services rendered.
Overcoding
Increases audit risk and potential penalties due to inflated billing.
Incorrect Modifier Usage
Misuse of modifiers like -25 or -59 can trigger denials or compliance issues.
Place of Service (POS) Errors
Incorrect POS codes might cause claims to be denied or underpaid..
NPI Misalignment
Billing under the wrong provider NPI affects claim validity and payment.
Unbundled Procedures
Separately billing services that should be grouped leads to compliance flags.
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