Medical Billing Audit Services

Are you facing financial challenges despite sending claims to payers? If so, you’re not alone. Most healthcare practices also face the challenge of maintaining accurate medical coding. BilNow provides medical billing and coding audit services to eliminate the root causes directly impacting revenue generation and regulation compliance.

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Mapping Your Success Navigating Audits with Precision & Care

We understand that it’s pretty challenging for healthcare providers to conduct financial audits while paying attention to patient care. Sounds familiar? Don’t worry! we‘ve got you covered. We have audit experts who handle the entire medical billing process. We take care of every aspect by verifying the medical records and billing data submitted to the payers. It is imperative to ensure that providers proactively identify, monitor, and correct inaccurate billing practices and potential compliance issues.

Certified Medical Billing

Best Auditors in the Business

Inaccurate or outdated codes can lead to denied claims, causing significant financial loss and potential compliance issues. To make the auditing process more efficient, we boast a network of the industry’s most highly trained auditors with expertise in multiple medical specialties. Our auditors ensure that your billing practices are accurate, compliant, and optimized to avoid costly mistakes caused by phantom billing, undercoding, upcoding, surprise medical bills, and other issues.

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Underpayment Recovery Don't Leave Your Hard-Earned Revenue On The Table

Underpayment recovery is the core of our work for healthcare providers. We make every possible effort to ensure your healthcare facility captures every dollar it deserves. Our audit team is a perfect combination of certified medical billers and coders who help you uncover payment variances, underpaid claims, and revenue lost due to aging accounts receivable. After root cause analysis, we offer affluent medical billing solutions to fix things and get your revenue cycle management back on track.  

In addition to recovering lost revenue, we provide ongoing support to prevent future underpayments. With our expertise and industry knowledge, you can be confident in achieving optimal payment accuracy and avoiding future revenue shortfalls.

Risk Adjustment Audits

With a thorough HCC audit, we help healthcare providers verify compliance and ensure accurate documentation and coding to avoid underpayments or inaccurate risk adjustments. Our structured methodology validates diagnosis coding accuracy for HCC categories and ensures that records meet CMS compliance standards. 

We help optimize your reimbursement process, prevent costly penalties, and ensure accurate reporting by thoroughly verifying the accuracy of your risk adjustment data, including diagnosis codes, hierarchical condition categories (HCCs), and risk scores. This ultimately leads to better patient outcomes and financial stability.

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Uncompromised Data Security

Recognizing the sensitivity of healthcare data, we prioritize its security by utilizing secure, encrypted systems, adhering to HIPAA compliance standards, and implementing comprehensive data security procedures. We sign strong nondisclosure agreements and ensure regular security monitoring to protect patient information. This ensures that all protected health information (PHI) is handled with strict secrecy, lowering the risk of data breaches or unauthorized access. Our commitment to data security makes us the most reliable medical billing company in the United States.

Our Medical Billing Audit Solutions

Medical Coding Compliance

We strictly adhere to the latest regulations and guidelines, ensuring that your medical coding practices are always compliant. Thus, we reduce the risk of penalties and denials.

HCC Coding and Auditing

We provide comprehensive Hierarchical Condition Category (HCC) coding and auditing to ensure accurate risk adjustment factor scores and optimize your revenue.

Clinical Audits

Experts scrutinize your clinical documentation for accuracy and completeness, enhancing the quality of patient care and supporting accurate billing.

Claims Management

The claims process receives expert management from initiation to completion, minimizing errors and maximizing successful reimbursements.

Coding Accuracy & Review

We thoroughly review your codes for accuracy, reducing the risk of denials and ensuring correct reimbursement.

Denials Management

We manage and investigate claim denials, finding the root cause and implementing solutions to reduce future denials and revenue loss.

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Post-Audit Education & Training

As part of our Post-Audit Education & Training program, we offer customized sessions designed to address your team’s coding and compliance challenges, ensuring enhanced accuracy and compliance with regulatory requirements.