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Medical billing audits are essential checkups to ensure that a provider’s billing claims and documentation meet compliance standards. Certified billing auditors review patient charts and billing records to verify the correct use of codes that match the services provided. Similar to routine health checkups, audits identify billing issues early, allowing providers to make necessary corrections.
Audits are crucial for uncovering improper billing, incomplete documentation, missed charges, and noncompliance with reimbursement guidelines. By proactively addressing these errors, audits help strengthen a provider’s revenue cycle and prevent denied claims or penalties for incorrect billing. Regular audits ensure accurate billing, proper documentation, optimal reimbursement, compliance with payer policies, and overall financial health.
About UsSystech Alliance operates as a professional medical billing audit services provider. Billing is complex and full of potential errors, requiring careful oversight. Our audit and compliance services provide this necessary monitoring, acting as a safety net to ensure the integrity of your entire medical claims process.
Our experienced billing auditors thoroughly review documentation, billing choices, and submitted claims to uncover inaccuracies and identify areas for improvement. Our findings help healthcare facilities achieve error-free billing and maximize revenue capture.Equally important, our high-quality audit program prevents billing compliance violations and fraud, avoiding fines, penalties, and damage to your reputation. Our audit service is a critical pillar for maintaining clinical, financial, and regulatory excellence.
We provide detailed reports to give you a comprehensive view of your billing operations. Below are some of the key reports you can request after auditing:
This report analyzes your charge capture process to identify areas of revenue leakage. We examine front-end billing issues that lead to missed charges and lost revenue, providing specific recommendations for improvement.
Our billing audit reviews a sample of records to identify billing errors and improvement opportunities. The report includes billing accuracy rates, the financial impact of errors, and highlights any education needs for billing staff. A risk analysis is also provided to help prioritize auditing efforts.
By analyzing your denial data, we identify common denial reasons, assess whether appeals are warranted, and pinpoint opportunities to prevent future denials. This report provides insights to reduce denials and improve revenue cycle performance.
This assessment evaluates your compliance risk levels in areas such as billing documentation, Medicare regulations, and HIPAA. We provide a scorecard that measures your exposure to risk and offer a roadmap for strengthening your compliance program.
How do your key performance indicators (KPIs) compare to industry standards? Our benchmarking report helps you assess metrics like first-pass resolution, net collection rate, A/R days, and more, so you can identify areas for improvement.