MEDICAL AUDIT SERVICES
Align with Your Payers and Patients for Better Understanding
At this stage, one may ask if you are fairly paid for offering excellent medical services to your patients. Instances of mistakes in healthcare billing often lead to revenue losses, and denied claims amongst other legal implications. As a result, medical billing audit solutions become necessary.
Med Revolve Billing offers healthcare coding and compliance auditing services. A team of trained auditors evaluates the accuracy, compliance and optimization of a provider’s claims resolving them in real-time. Save your practice from trouble by talking to us right away as we will address all your worries regarding audits.
OUR SERVICES
What Medical Audit Services Do We Offer?
Medical Coding Audit
Furthermore, we make sure to conduct audits on diverse medical records like inpatient, outpatient, professional and home health in order to ensure accurate medical coding.
Medical Biling Audit
Medical coding is the main reason why we check out different types of medical records, which include inpatient, outpatient, professional and home health as well.
Government & Payor Mandated Audit
We ready providers for and address audits mandated by government and payors, including TPE, RAC, OIG, DMEPOS, and Medical Necessity audits.
Clinical Audit
We also do a clinical assessment both within the organization and outside it, and this evaluates quality and security of patient treatment as well as outcomes.
HIM Audit
HIM audits are carried out by us for functions such as record retention and destruction, data integrity, and Electronic Health Records (EHR).
Medical Auditing Solutions
Enhance Clinical Outcomes and
Reduce Compliance Risk
To adhere to billing standards, improve clinical outcomes, and prevent healthcare fraud, it is necessary to conduct medical audits. Nevertheless, providers may find themselves in difficult times while doing these audits due to the inability of individuals in conducting them, inadequate resources available for them or fear of being penalized by government agencies for unintentional errors. In other words, you need reliable health care coding and compliance audit services.
Our competent auditors use sophisticated data analytics to perform all-encompassing and unbiased audits that yield exhaustive reports, recommendations, corrective action plans as well as appeals where required. We are confident that our solutions can eliminate inaccuracies in coding and billing processes, optimize remuneration policies for employees, improve legal compliance levels as well as reduce business risks exposure thus enhancing efficient service delivery that enhances patient satisfaction in healthcare organizations.
Are you in the dark about
the quality of your medical records?
Let us shed some light on them!
Medical ISO Audit Services
Improve Your Lab’s Operations with our
ISO 15189 Audit
ISO 15189: Standard for the quality and competence of medical laboratories.
This is the standard that defines the requirements of a quality management system that encompasses all laboratory activities from pre-examination to post examination process.
ISO 15189 Audit Services by Med Revolve Billing ensures compliance with international standards and regulations in medical laboratories. Our medical audit service helps labs to:
- Help providers get paid and provide better patient care
- Improve cash flow by speeding up claims payments
- Identify and resolve any billing issues that may be delaying payments.
- Reduce administrative burdens by automating claim processing.
- Avoid revenue leakage by identifying and correcting any errors in billing.
Complete Medical Audit Solutions
We Optimize Your Medical Billing and Coding Processes
Internal Audit
Our work involves a detailed examination of the internal processes and documentation you have to ensure that they are in accordance with the industry standards. At the same time, we also make suggestions on how to enhance provider performance.
External Audit
We independently investigate the claims you make and payments made by third-party payers such as Medicaid or Medicare. Our professional team is very good at solving billing arguments, collecting money for services billed, and working on past due accounts.
Prospective Audit
Our team of experts will perform an independent evaluation of your claims and payments from third-party payers such as Medicare and Medicaid. We recover underpayments, work with aged receivables, and resolve billing disputes.
Retrospective Audit
After the payers have finished processing your claims, we examine them to ascertain if there are any mistakes in them. In addition, we see to it that you correct the mistakes and appeal any denials made so that your revenue cycle is optimized.
Comprehensive Audit
We offer a comprehensive approach to auditing your whole medical practice whereby we assess all the areas of operations like coding and billing, documentation and compliance. Besides, we assist you in attaining best quality standards and profit maximization.
Medical Chart Reviews and Validations
Enhance Your Data Quality and Compliance
Med Revolve Billing – a best medical Billing agency – employs certified doctors, auditors and clinicians who can perform different kinds of reviews on your healthcare records such as:
Patient Medicare Eligibility Verification
This managed billing service of ours handles hospital’s back office operations thus enabling providers to focus on patient care. The patient preauthorization is a process that ensures the correct identification and in turn insurance information to guarantee the eligibility for requested services. The remodeled medical AI system possess an automated feature that helps scan all patients’ authorizations for any missing information or incomplete ones that may lead to delays in care provision.
Onboarding Providers into Payer Networks
New medical practitioners are assisted by Med Revolve medical billers in getting paid and keeping their operations running smoothly. We provide fast-tracked licensing, credentialing and enrollment into lucrative payer networks. Our Medical billing assistants minimize the time taken to get new clinical personnel on board so that they can be given clinical privileges quickly. Any kind of physician, non-physician, DEA, CDS or CLIA license is supported.
Advanced KPI Tracking
Powerful analytics tools can help medical service providers monitor important KPIs such as high-value clients and areas of excessive costs. Data analytics such as these allow doctors to maximize their income streams by providing them the knowledge necessary for effective business decision making. This technology can be used to help identify the most effective advertising efforts, or even the right price point for certain services, like medical treatment.
Risk Adjustment Data Validation
We can confirm the precision of your risk allocation records through diagnosis codes, HCCs, and risk scores. This will enable you to increase your returns, evade penalties as well as make progress in patient services.
Are your claim submissions accurate?
Let us do a health check for your practice.