MEDICAL BILLING & CODING AUDIT SERVICES
Stay aligned with your payers and patients!
Ensuring you get paid what you deserve for quality patient care is crucial. Medical billing errors can lead to lost revenue, denied claims, and legal issues, making medical billing audit services essential.
Konnext Solution specializes in healthcare coding and compliance audit services for providers. Our experienced billing auditors meticulously review billing codes for accuracy, compliance, and optimization, with real-time issue resolution. Don’t risk your practice—contact us today to ensure medical billing compliance and maximize revenue.
What are Medical Billing Audits?
Medical billing and coding audits are essential evaluations that ensure a provider’s billing claims and coding documentation meet medical billing compliance standards. Certified billing auditors meticulously examine patient charts and billing records to verify the use of accurate codes that appropriately reflect conditions and care provided. Similar to routine physical exams that detect health issues early, audits diagnose billing issues, enabling providers to take corrective actions.
Audits are critical as they uncover improper coding, incomplete documentation, missed charges, and noncompliance with reimbursement guidelines. This proactive approach strengthens a provider’s revenue cycle by correcting errors before they result in denied claims or penalties for incorrect billing. Regular comprehensive audits are advantageous as they ensure proper coding, completeness of records, optimal reimbursement, compliance with payer policies, and overall financial health.
How does Konnext Solutions' Medical Coding Audit Service benefit you?
KonnextSolutions offers professional medical billing audit services, providing vigilant oversight to ensure accuracy and integrity in medical billing and coding. Our experienced billing auditors meticulously review documentation, coding choices, and submitted claims to identify inaccuracies and enhance billing cycle efficiency. Our audit program also safeguards against billing compliance violations and fraud, supporting clinical, financial, and regulatory excellence.
Medical Coding Audit
We do medical coding audits for all types of medical records, including inpatient, outpatient, profee, and home health.
Medical Billing Audit
We do medical billing audits for all types of claims, including Medicare, Medicaid, commercial, and self-pay.
Government & Payor Mandated Audit
We prepare providers for and respond to government and payor mandated audits, such as TPE, RAC, OIG, DMEPOS, and Medical Necessity.
Clinical Audits
We conduct internal and external clinical audits to assess the quality and safety of your patient care and clinical outcomes.
Collection Aging Audit
We improve your cash flow by auditing your aged claims for errors and refiling denied claims with our collection aging audit.
Auditing Medicare Patient Charts
We audit Medicare patient charts, ensuring every dollar billed is justified and compliant, so your practice gets fully and fairly paid.
Are you in the dark about the quality of your medical records?
Let us shed some light on them!
Billing Errors
Affect the financial stability, cash flow, profitability, and sustainability of the healthcare organization.
Clean Billing Claims
With our comprehensive billing audit, we thoroughly examine each claim to verify correctness, securing maximum appropriate reimbursement to maintain financial health and endurance of your healthcare institution.
Coding Errors
Lead to claim denials, loss of revenue, overcharges, underpayments, patient dissatisfaction, and legal actions.
99% Claim Acceptance
We deploy advanced NLP and machine learning techniques to analyze medical records and catch coding mistakes, optimizing reimbursement and circumventing claim denials down the line.
Compliance Issues
Result in penalties, fines, audits, investigations, lawsuits, sanctions, and exclusion from federal health programs.
Meet Billing Compliance
Our robust billing analytics engine identifies trends, outliers and red flags in real-time, allowing for targeted audits to eliminate compliance risks and avoid government scrutiny.
Reimbursement Cuts
Could force healthcare providers to reduce staff, limit services, close practices, or accept fewer Medicare patients.
Maximum Reimbursements
Our proprietary AI-powered billing audit system analyzes your claims data to identify missed revenue opportunities and compliance risks, ensuring every penny is captured before reimbursement cuts hit your bottom line.
We Optimize Your Medical Billing and Coding Processes
FREE AUDIT
Missing Money? We'll Find It.
Our specialized audits dig deep into your claims data and billing records to recover improper payments and missed revenue.
Konnext Solutions Auditing Solutions To Date
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Coding Errors Resolved
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Our Coding Audit Service Promises Billing Compliance: Here’s How?
Auditing your coding accuracy
Assessing coding accuracy is a principal objective of our medical coding audit company. We thoroughly investigate medical charts to ensure codes mirror the diagnosis, completed procedures, and complexity level. Proper coding is vital for correct reimbursement and adherence to guidelines. Our audits identify any upcoding or undercoding issues and recommend remedial actions. With our assistance, doctors can have confidence their coding satisfies standards and captures the total value due.
Improving your charge capture accuracy
Another essential element we examine is charge capture. We validate that all services rendered and supplies used are captured in the billing at the appropriate rates. Missed charges lead to lost revenue. Our auditors diligently compare the documentation in the medical record to the itemized billing statement. We identify any missed charges and recommend improvements to charge capture processes. Our goal is to maximize your reimbursement by closing gaps where legitimate charges are overlooked.
Auditing your billing documentation for compliance
Thorough documentation review is also part of our billing audit process. We assess whether the medical record provides clear, consistent documentation that supports the coded claims. Complete, accurate documentation is required to justify charges and pass payer scrutiny. Our team flags any documentation issues like vagueness, inconsistency, missing signatures/credentials, or lack of medical necessity. We provide guidance to strengthen documentation practices for better claim defense and audit survival.
Performing audits of provider-payor contracts
Some other areas we examine are proper application of insurance payor contracts and fee schedules as well as accuracy of data entered into the billing system. Invalid fee schedules and data entry errors can sabotage reimbursement. We verify compliance with payer contracts and recommend process improvements to enhance billing system accuracy. Our comprehensive audits cover all key facets to maximize claim quality and revenue integrity.