- 844-735-5084
- info@techmedsolutions.co
- 595 Stewart Avenue Suite 550 Garden City NY 11530
Maximize Revenue with
Comprehensive Medical
Billing Audit Services
How Can Tech Med Solutions Assist with Medical Coding Audits?
Tech Med Solutions works as a professional medical billing audit services company. Medical billing and coding is complex work full of pitfalls for error, calling for vigilant oversight. Therefore, our medical coding audit and compliance services provide this monitoring, serving as a safety net that preserves the integrity of the entire medical claims billing process.
The experienced billing auditors at Tech Med Solutions , take a magnifying glass to documentation, coding choices, and the submitted claims to unveil inaccuracies and illuminate opportunities for billing cycle improvement. Our findings steer healthcare facilities toward error-free medical coding and full revenue capture.
Medical Billing Audits Explained
Medical billing and coding audits are essential evaluations that ensure a provider’s billing claims and coding documentation align with medical billing compliance standards. Certified auditors review patient charts and billing records to verify the use of accurate codes that correspond to diagnoses and treatments. Similar to routine checkups for health, these audits identify potential issues early, enabling providers to make timely corrections.
Audits play a crucial role in uncovering improper coding, incomplete documentation, missed charges, and noncompliance with reimbursement guidelines. By addressing these issues proactively, providers can strengthen their revenue cycle, minimize denied claims, and avoid penalties for billing inaccuracies. Regular, comprehensive audits help ensure accurate coding, complete records, optimal reimbursement, adherence to payer policies, and overall financial stability.
Explore Our Medical Billing Audit Services
Medical Coding Audit
We provide thorough medical coding audits for all types of medical records, including inpatient, outpatient, professional fee (profee), and home health, ensuring accuracy and compliance across all healthcare settings.
Medical Billing Audit Services
We conduct detailed audits for all claim types, including Medicare, Medicaid, commercial insurance, and self-pay, ensuring accuracy and compliance across the board.
Government & Payor Audit
We assist providers in preparing for and responding to government and payor-mandated audits, including TPE, RAC, OIG, DMEPOS, and Medical Necessity.
Clinical Audits For Quality
We perform both internal and external clinical audits to evaluate the quality, safety and effectiveness of your patient care and clinical outcomes
Aging Claims Audit
Our collection aging audit helps boost your cash flow by identifying errors in aged claims and refiling denied claims for prompt resolution.
Medicare Chart Audits
We audit Medicare patient charts to ensure all billed amounts are justified and compliant, ensuring your practice receives full and fair reimbursement.
Solve Your Billing Challenges with Our Auditing Solutions
Inaccurate billing and coding can significantly impact your practice. Denied claims result in lost revenue, backlogs cause cash flow issues, and errors lead to audits and penalties. Our medical billing and coding audit service identifies inefficiencies in your workflows. After a thorough analysis of your team, processes, and technology, we provide targeted recommendations to improve compliance and optimize your revenue cycle.
Using advanced NLP and machine learning, we analyze medical records to detect coding errors, optimize reimbursements, and prevent claim denials.
Non-compliance can lead to penalties, fines, audits, investigations, lawsuits, sanctions, and exclusion from federal health programs.
Our advanced billing analytics engine detects trends, outliers, and red flags in real-time, enabling targeted audits to mitigate compliance risks and prevent government scrutiny.
The Impact of Billing Errors
Billing errors can threaten the financial stability, cash flow, profitability, and long-term sustainability of healthcare organizations.
Our comprehensive billing audit carefully reviews each claim for accuracy, ensuring maximum appropriate reimbursement to support the financial health and long-term stability of your healthcare organization.
Coding errors can result in claim denials, revenue loss, overcharges, underpayments, patient dissatisfaction, and potential legal consequences.
Reimbursement reductions may compel healthcare providers to cut staff, limit services, close practices, or accept fewer Medicare patients.
Our AI-powered billing audit system analyzes your claims data to uncover missed revenue opportunities and compliance risks, ensuring every dollar is captured before reimbursement cuts
How Our Coding Audits Guarantee Accurate and Compliant Billing
Ensuring Accurate Coding
At our medical coding audit company, assessing coding accuracy is a key focus. We carefully review medical charts to ensure that codes accurately reflect diagnoses, procedures, and complexity levels. Proper coding is essential for correct reimbursement and compliance with guidelines. Our audits identify issues such as upcoding or undercoding and provide recommendations for correction. With our expert support, providers can be confident their coding meets industry standards and captures the full reimbursement value owed.
Enhancing Charge Capture Accuracy
Charge capture accuracy is another critical area we focus on. We ensure that all services rendered and supplies used are correctly captured in the billing at the appropriate rates. Missed charges result in lost revenue, which is why our auditors meticulously compare medical records with itemized billing statements. We identify any overlooked charges and provide recommendations to improve your charge capture processes. Our aim is to maximize your reimbursement by addressing gaps where legitimate charges may be missed.
Auditing Provider-Payer Contracts
Some other areas we examine are proper application of insurance payor contracts and fee schedules as well as accuracy of data entered into the billing system. Invalid fee schedules and data entry errors can sabotage reimbursement. We verify compliance with payer contracts and recommend process improvements to enhance billing system accuracy. Our comprehensive audits cover all key facets to maximize claim quality and revenue integrity.
Auditing Billing Documentation for Compliance
A comprehensive documentation review is a key component of our billing audit process. We evaluate whether medical records provide clear and consistent documentation to support the coded claims. Complete and accurate documentation is essential to justify charges and withstand payer scrutiny. Our team identifies any documentation issues, such as vagueness, inconsistency, missing signatures or credentials, and lack of medical necessity. We offer guidance to enhance documentation practices, ensuring better claim defense and improved audit outcomes.
How Our Coding Audit Services Ensure Billing Compliance
Receive Post-Audit Reports Directly to Your Inbox
We deliver detailed reports that offer a comprehensive view of your coding and billing operations. Below are some key reports you can request after the audit
Charge Capture Analysis Report
This report evaluates your charge capture process to pinpoint areas of revenue leakage. We focus on front-end charge capture issues that result in missed charges and lost revenue. The report includes actionable recommendations to improve charge capture efficiency and maximize revenue.
Coding Audit Report
Our coding audit reviews a sample of charts to identify errors and opportunities for improvement. The report highlights coding accuracy rates, the financial impact of errors, and outlines education needs for coders. Additionally, we provide a risk analysis to help prioritize auditing efforts and enhance overall coding practices.
Denials Analysis Report
This report analyzes your denial data to identify the primary denial reasons, determine if appeals are necessary, and uncover opportunities to prevent future denials. Our findings provide actionable insights to help reduce denials and improve your overall revenue cycle performance.
Compliance Risk Assessment Report
This report evaluates your compliance risk in areas like coding and billing documentation, Medicare regulations, and HIPAA. We provide a risk scorecard and a detailed roadmap to help strengthen your compliance program and reduce potential risks.
Revenue Cycle Performance Report
How do your KPIs measure up? Our benchmarking report compares your metrics to industry standards, helping you identify areas for improvement. We analyze key indicators such as first-pass resolution, net collection rate, A/R days, and more.