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Billing & Coding Audit

Data to discover the root cause of all Denials.

Get Paid More Quickly With

Billing & Coding Audit

Data to discover the root cause of all Denials.

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Billing & Coding Audit

We understand the importance of conducting regular audits of medical billing and coding processes to ensure accuracy and efficiency in the revenue cycle. Our audit services help medical practices mitigate risk, optimize revenue, and improve their overall performance. In addition to identifying and addressing any issues, our audits also serve as an educational tool, helping practices understand the complexities of medical coding and billing. We review coding quality to ensure accuracy and identify areas of strength and weakness to help practices establish a quality assurance process.

Advantages Of Conducting Billing and Coding Audits

Routinely conducting audits provides healthcare organizations and providers with several advantages. When you partner with Pro Medical Billing Solutions for your medical billing audits, you take a proactive step towards:

Pro Medical Billing Solutions helps healthcare providers optimize claim performance by reducing the number of denials. In medical practices, the rate of claim denials is often higher than 10%, which can significantly impact the financial health of a healthcare organization. Pro Medical Billing Solutions works with healthcare providers to identify potential issues that may lead to denials and address them, improving the performance of their billing processes.

Pro Medical Billing Solutions helps ensure compliance with HIPAA and other industry regulations, such as FCA, AKS, and Stark Law, through regular medical billing and coding audits. These audits identify and address any potential compliance issues, provide opportunities for risk assessment, and protect against fraudulent billing activity and claims. By conducting these audits, Pro Medical Billing Solutions enhance the efficiency of billing and coding processes for its clients, helping them avoid legal penalties and damage to their reputation.

Audit identifies and addresses any issues that may be causing inefficiencies in the billing process, allowing practices to run more smoothly and efficiently. By setting standards for office staff and implementing policies and procedures that create a positive work environment, medical practices can improve productivity, cost efficiency, communication, and time management. In addition, a culture of compliance can attract and retain talented employees. By working with Pro Medical Billing Solutions, clients can streamline their workflow and focus on providing high-quality patient care.

Regular audits are an important tool for maintaining quality and performance in a healthcare organization. By keeping an eye on processes and identifying and addressing issues on time, regular audits help to ensure that all operations are running smoothly and efficiently. This, in turn, helps to improve patient care and satisfaction, as well as financial performance. Regular audits also help to ensure compliance with industry regulations and standards, which is crucial for the success and reputation of any healthcare organization. Overall, regular auditing is an essential part of maintaining quality and performance in medical practice.

Audit result provides valuable opportunities for education and training within a healthcare organization. By identifying areas of weakness or improvement, audits helps identify specific areas where staff may need additional training or education in order to improve their performance. This also helps to ensure that staff are up-to-date on the latest industry standards, which will help reduce errors and improve the overall efficiency of the organization's billing and coding processes. Additionally, by providing regular training and education to staff, organizations can foster a culture of continuous learning and improvement, which can help improve overall quality and performance

Billing and Coding Audits
Risk Based Audit

Risk Based Audit

We'll look at all the codes you are currently charging and compare them to national averages. Our goal is to let you know your coding practices follow best practices and eliminates your risk of committing fraud.

Focused Audit

Focused Audit

If you know you have a problem with your ICD-10 or E/M codes, then we can review the specific area that is challenging you to help you get things corrected.

Regularly Scheduled Audit

Regularly Scheduled Audit

Once evaluated, some clients sign on for recurring audits to ensure that they continue to follow best practices. The schedule and complexity of the audits can be customized to your needs.

Billing & Coding Audit Process we follow

Pro Medical Billing Solutions recognizes the vital role that medical billing and coding audits play in the smooth operation of our clients’ billing processes. To this end, we have developed a thorough audit process that includes the following steps

 High Data Security

Review of billing and coding policies

Focus on Patient Care
We understand the importance of regularly reviewing our clients' billing and coding policies to ensure that they are current and compliant with industry standards. By carefully reviewing our clients' policies, we can identify any potential issues and work with them to implement any necessary changes to ensure that their billing processes are running smoothly and efficiently.
Data analysis

Data analysis

As part of our medical billing and coding audit process, Pro Medical Billing Solutions conducts a detailed analysis of our clients' billing and coding data. This allows us to identify any trends or areas for improvement that may be impacting the efficiency and effectiveness of their billing processes.
State of the Art-Architecture

On-site review

During an on-site review, we may review our clients' billing and coding practices, including reviewing patient charts and other relevant documentation. This allows us to get a first-hand understanding of our clients' billing processes and identify any issues or areas for improvement that may not be apparent from reviewing data alone.
Single Point of Contact

Report and Recommendations

Ensure Billing Compliance
Pro Medical Billing Solutions prepares a detailed report that outlines any issues or areas for improvement that we have identified. This report includes specific recommendations for addressing these issues and improving our clients' billing and coding processes. By providing our clients with clear, actionable recommendations, we are able to help them optimize their revenue cycle and improve their bottom line.
 Experience Staff

Follow-up

Provide Staffing Consistency
At Pro Medical Billing Solutions, we understand the importance of providing ongoing support to our clients to ensure that their billing and coding processes are running smoothly, we work with our clients to implement the recommended changes and continue to monitor their billing and coding processes to ensure that they are running efficiently.
We understand the importance of regularly reviewing our clients' billing and coding policies to ensure that they are current and compliant with industry standards. By carefully reviewing our clients' policies, we can identify any potential issues and work with them to implement any necessary changes to ensure that their billing processes are running smoothly and efficiently.
As part of our medical billing and coding audit process, Pro Medical Billing Solutions conducts a detailed analysis of our clients' billing and coding data. This allows us to identify any trends or areas for improvement that may be impacting the efficiency and effectiveness of their billing processes.
During an on-site review, we may review our clients' billing and coding practices, including reviewing patient charts and other relevant documentation. This allows us to get a first-hand understanding of our clients' billing processes and identify any issues or areas for improvement that may not be apparent from reviewing data alone.
Pro Medical Billing Solutions prepares a detailed report that outlines any issues or areas for improvement that we have identified. This report includes specific recommendations for addressing these issues and improving our clients' billing and coding processes. By providing our clients with clear, actionable recommendations, we are able to help them optimize their revenue cycle and improve their bottom line.
At Pro Medical Billing Solutions, we understand the importance of providing ongoing support to our clients to ensure that their billing and coding processes are running smoothly, we work with our clients to implement the recommended changes and continue to monitor their billing and coding processes to ensure that they are running efficiently.

By carefully reviewing our clients’ billing and coding policies, analyzing their data, conducting on-site reviews, and providing recommendations for improvement, we are able to identify issues that may be impacting their revenue and offer solutions for addressing them. By implementing the recommended changes and continuing to monitor our clients’ billing and coding processes, we are able to help them optimize their revenue cycle and improve their bottom line. Whether you are a small private practice or a large healthcare organization, we have the expertise and resources to help you optimize your billing processes and maximize your revenue.

Why Choose Pro Medical Billing Solutions for Medical claims processing?

Our team comprises of extremely skilled and well-experienced Medical Billing and Coding professionals who are capable of handling any type of Billing requests – Being an ISO certified organization, you can rest assured that all the Medical Billing & Coding Services delivered by our team will be of the best quality and error-free.

What Makes Us the Preferred Medical Billing Services Company?

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Client Satisfaction

Client Satisfaction

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(FPPR) First-Pass Resolution Rate

FPPR

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Denial & Rejection

0 % - 10%
Client Retention

Client Retention

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Electronic Claim Rate

Electronic Claim

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Electronic Payment Percentage

Electronic Payment

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We're here to help

24/7 – Let’s have a call with someone Executive next 30 minutes – No more away!!!

Here are the top specialties , We are helping healthcare physicians throughout the United States to address their Medical Billing challenges.

Our team of experts specializes in the following areas, which are known to be the most impactful for improving Medical Billing efficiency and accuracy.

If you are searching for a dependable Medical Billing Company - You've found it - Contact us today to learn more about Our services!

Gastroenterology Billing Services

Gastroenterology Billing Services

Cardiology Billing Services

Cardiology Billing Services

Physical Therapy Billing Services

Physical Therapy Billing Services

Neurosurgery Billing Services

Neurosurgery Billing Services

Pediatric Medical Billing Services

Pediatric Medical Billing Services

Chiropractic Billing Services

Chiropractic Billing Services

Pain Management Billing Services

Pain Management Billing Services

Behavioral Health Billing Services

Behavioral Health Billing Services

Internal Medicine Billing Services

Internal Medicine Billing Services

Orthopedic surgery Billing Services

Orthopedic surgery Billing Services

Plastic surgery Billing Services

Plastic surgery Billing Services

Vascular surgery Billing Services

Vascular surgery Billing Services

Radiation oncology Billing Services

Radiation oncology Billing Services

Urology Billing Services

Urology Billing Services

Otolaryngology Billing Services

Otolaryngology Billing Services

Radiology Billing Services

Radiology Billing Services

Dermatology Billing Services

Dermatology Billing Services

Anesthesiology Billing Services

Anesthesiology Billing Services

Ophthalmology Billing Services

Ophthalmology Billing Services

General surgery Billing Services

General surgery Billing Services

Oncology Billing Services

Oncology Billing Services

Colon and Rectal Billing

Colon and Rectal Billing Services

Groups we serving!

- Patient Scheduling

- Verification of Benefits

- Authorization & Referral

- Medical Billing

- Medical Coding

- Charge Entry & Payment Posting

- Billing & Coding Audit

- Denial Management

- AR Management

- Old AR Recovery

- Patient Billing & Statements

- Collections Services

- Patient Help 24/7

Here are the top specialties, We are helping healthcare physicians throughout the United States to address their Medical Billing challenges.

Our team comprises of extremely skilled and well-experienced Medical Billing and Coding professionals who are capable of handling any type of Billing requests – Being an ISO certified organization, you can rest assured that all the Medical Billing & Coding Services delivered by our team will be of the best quality and error-free.

If you are searching for a dependable Medical Billing Company - You've found it - Contact us today to learn more about Our services!

Groups we serving!

- Patient Scheduling

- Verification of Benefits

- Authorization & Referral

- Medical Billing

- Medical Coding

- Charge Entry & Payment Posting

- Billing & Coding Audit

- Denial Management

- AR Management

- Old AR Recovery

- Patient Billing & Statements

- Collections Services

- Patient Help 24/7

Medical Billing Software We Leverage for Revenue Cycle Management

Here are some Industry top listed EHR being operates by Us.

Our Valued Clients

With Pro Medical Billing Solutions our transition from one E.H.R to another was easy. They are extremely responsive and answer all my inquiries immediately. Reimbursement ratio is at all time high since we became partners. The billing staff is knowledgeable and available whenever needed.

Sam Carr - MD Olympic RCM

Being working with Management of Pro Medical billing solutions for almost last 8 years, I am immensely satisfied with their RCM services and updated knowledge of any changes in guidelines. Their positive and professional work attitude and timely reporting had increased our practice collection...

David Feeback - CFO Colorado Health and Providers

Appreciation for you guys. You all have made a life here smoother than I could have imagined! Your response times are impressive! Your staff is Awesome! You all have been the best, outsourced billing company I’ve worked with.

Nell Sampson - Practice Admin G&A Wellness Clinic

Our collections have remained incredible from the last 15 months , our first pass rates increased and our PC% are above industry standards. You Guys are highly responsive, I would recommend Pro Medical Billing Solutions for any practice wanting to take control of their revenue cycle. We simply don’t worry about collections.

Dr. Mukherjee Ranadev - MD CO-FOUNDER Digestive Associates

We are happy that we found Pro Medical Billing Solutions which is the right billing service Solution. Our revenues since switching have improved and we appreciate them. Professional and loyal team, always available for help.

Maria Balderaz - Practice Administrator Alliance Risk Group

Extremely you guys are doing an amazing effort getting our revenue up and cash flow is getting better than before! Thank you for your wonderful effort. Thumbs-up to you and your team.

Dr. Jorge Guevara - MD Outcomes Detox & Recovery Center

This is our third year with Pro Medical Billing Solutions, before we had a bad experience with some billing companies. Pro Medical Billing Solutions have talented young people and professionals who run our business with great ease.

Dr. Charles Sisson Integrated Medical Consultants

I am very satisfied with the service of Pro Medical Billing Solutions. The team's responses are very quick to my emails and questions. Our repayment rate is very healthy. We receive our weekly and monthly reports on time. The team always highlights problems with solutions.

Steffhanie Laurel Director of Operations (Colorado Clinic)
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    Years of Experience

    Satisfied Providers