Medical Audit

Medical Billing Audit Services | Compliance Audit

Clinic IT offers a fool proof solutions for auditing medical claims by combining verified audit procedures, knowledgeable personnel, and the most reliable analytics technology.

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Medical Billing Audit Services | Compliance Audit

Clinic IT medical billing audit services involve the systematic assessment of physician practices within a healthcare organization. A medical billing audit can be performed on the various components within the organization. Still, most commonly audit is performed on the elements concerned with the insurer reimbursement process to assess whether the billing and coding implications for physician practices comply with regulatory authorities’ regulations and guidelines.

Although your front office can perform audits manually, It is a big challenge for them to understand and recognize the thousands of CPT codes for the rendered service. Additionally, your front office is partially aware of the physician’s specialties’ procedural coding complexities; hence their manual and self-practices lead them towards typos mistakes. It results in the submission of a false claim. Ultimately, medical providers are overwhelmed by their practice’s revenue irregularities and losses and put their organization at risk of extensive audits by the government.

Why Choose Us?

We help maximize revenue collections and boost revenue substantially.
We are a team of certified coders having in-depth knowledge and expertise in using codes.
We understand the importance of coding accuracy in reducing claim denials and rejections.
We ensure error-free coding.
We ensure that regular updates are sent to the provider.

How Does We Perform Seamless Medical Coding Services?

Clinic IT is renowned as one of the leading medical coding outsourcing companies, providing top-notch outsourced coding services to physicians, hospitals, and healthcare facilities. We provide specialized and best-practice coding solutions crafted to align perfectly with your unique requirements, ensuring the industry’s highest standard of best practices.
Our experts go through several steps to ensure accurate coding and enhanced revenue. Let’s take a bird’s eye view of our basic steps

Expert Professionals

Clinic IT’s billing auditors are highly skilled professionals with years of experience in the medical field. Serving physicians across the U.S., our experts deliver reliable medical billing audit solutions. Their vast knowledge ensures accurate and effective audits tailored to each practice’s needs. We leverage their expertise to enhance the financial health of medical practices.

Clean Submission approach

We address claim rejections by identifying and correcting deficiencies that lead to denials. After a thorough review, our experts resubmit claims with necessary adjustments. This process maximizes reimbursement and ensures accuracy in claims submission. Our clean submission approach helps optimize revenue recovery.

Audit Tool

Our auditors use advanced audit software to meticulously review medical records. The audit tool helps in generating detailed reports and analyzing data efficiently. It ensures thorough examination and accurate documentation of audit findings. This technology supports our commitment to precision in every audit.

Audit Analysis and Summary Report

Our audit findings are presented in a clear and detailed summary report. We categorize and explain each audit finding, highlighting trends, errors, and areas for improvement. The report includes citations to relevant standards and provides actionable insights. This helps practices understand their audit results and necessary corrections.

Specialized Practice Revenue Experts

Clinic IT’s revenue experts analyze practice revenue cycles in detail. They identify critical issues and develop solutions to improve financial health. Working with auditors, they ensure comprehensive evaluation of financial operations. Their expertise enhances overall practice efficiency and revenue management.

Training your staff

We review audit findings with your staff to address risks and corrective actions. Our reports are designed for both physicians and front staff, highlighting strengths and areas for improvement. We offer targeted training to enhance coding and compliance skills. Our goal is to ensure staff understand and apply best practices effectively.

Initial Consultation and Objective Setting

Our audit process begins with an in-depth consultation to understand your specific needs and goals. We collaborate with your team to define the scope of the audit, identify key areas of focus, and establish clear objectives. This ensures that our audit aligns with your organization's compliance requirements, financial goals, and operational efficiency.

Data Collection and Analysis

We gather comprehensive data from your medical records, billing systems, and operational processes. Our team of experts uses advanced auditing tools and methodologies to meticulously review and analyze this data. We focus on identifying discrepancies, coding errors, compliance issues, and areas where financial performance can be optimized.

Detailed Reporting and Findings

After the data analysis phase, we compile a detailed report that highlights our findings. This report includes a summary of identified issues, root cause analysis, and the potential impact on your organization. We provide actionable insights and recommendations to address any compliance risks, improve coding accuracy, and enhance revenue cycle management.

Implementation Support and Follow-Up

Our commitment to your success extends beyond the audit report. We work closely with your team to implement the recommended changes and improvements. Additionally, we offer follow-up audits and ongoing support to ensure that the corrective measures are effective and that your organization remains compliant and financially efficient in the long term.

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Testimonials

“They say, 'What you don’t know won’t hurt you,' but ClinicITSolutions has certainly proved that wrong. Pete guided our group through an audit that revealed just how incompetent our previous RCM team was. Since CIS took over our RCM and brought on team leaders like Ashley, we’re already seeing significant results. It's also reassuring that Pete didn't just disappear after we signed on with CIS—he's still with us every step of the way. It's inspiring to see people like Pete and Ashley, who are passionate about their work and genuinely believe in the company”

Dr. Giancarlo / French Medical Health

“ClinicITSolutions is a doctor’s billing service that has done a remarkable job of improving our pediatric medical group’s revenue since we started using them six months ago. Their excellent team promptly contacts us if any patient billing information is missing on claim forms, and they diligently follow up on rejected claims from insurance, ensuring they are resubmitted.”

Dr. Usman Khalid / Pride Health Wellness

Our practice has been working with ClinicITSolutions since last year, and they have significantly improved our billing and collections. Their services have streamlined our workflow and freed up resources, allowing us to focus on the most pressing matters in our practice. Thank you to the team for always being available and easy to communicate with.

Dr. Yvonne, Health Clinic

FAQ

Frequently Asked Questions from Our Community

We cut through today’s complexity and use whatever technology it takes to get you where want to be.

Have Questions?

What is a medical billing audit?

A medical billing audit is a thorough review of a healthcare provider's billing practices to ensure accuracy, compliance with regulations, and proper reimbursement. It involves checking coding accuracy, documentation, and adherence to billing guidelines.

Why is a medical billing audit important?

Audits help identify and correct errors, prevent fraud, ensure compliance with regulations, and improve revenue cycle management. They also help avoid potential penalties and enhance overall billing efficiency.

How often should medical billing audits be conducted?

It is recommended to conduct audits at least annually. However, more frequent audits may be necessary if there are significant changes in billing practices, new regulations, or an increase in claim denials.

What are the common issues found during a medical billing audit?

Common issues include coding errors, incomplete or incorrect documentation, non-compliance with billing guidelines, unbundling of services, and duplicate billing.

Who should perform a medical billing audit?

Audits should be performed by experienced and certified professionals, such as Certified Professional Coders (CPCs) or auditors with expertise in medical billing and compliance.

What can I expect from your audit services?

From our audit services, you can expect a comprehensive review of your billing practices, detailed reports highlighting findings, actionable recommendations for improvement, and ongoing support to implement changes.

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