We provide comprehensive medical claims auditing to ensure their compliance with national and international medical and administrative guidelines. They are necessary to determine areas that require improvements and corrections.
Medical claims audit specifically targets and evaluates procedural, and diagnosis code selection as physician documentation determines. Once the audit reveals the areas of weakness, you can present the audit findings and identify opportunities for training in your health care organization.
What Is Medical Auditing and Why Perform One?
Medical auditing entails conducting internal or external coding accuracy reviews, policies, and procedures to ensure you are running an efficient and hopefully liability-free operation.
It also educates the providers on documentation guidelines.
Medical Audit Value Proposition:
There are many reasons to perform medical audits:
- It plays an essential role in providing accurate and efficient documentation for any healthcare organization.
- It figures out the areas that the healthcare provider needs to improve.
- It helps early detect irrelevant coding and correct any mistake before sending it to the insurance company.
- It helps to avoid any fraudulent activities.
- Early detection of any outliers before the payers find them in their claims software and request an internal audit.
- Provide feedback for quality improvement.
- It helps to improve the quality of patient care.
