Medical billing audit & A/R review
A medical billing audit is an independent check on whether your claims are being billed, followed up and collected the way they should be. We review aging A/R, unworked and rejected claims, write-offs and adjustments, and how your in-house team or outside billing company is actually performing.
Signs you need a billing audit
- A/R over 90 or 120 days keeps growing
- You suspect your billing company isn't performing, but can't prove it
- Rejected claims sit at the clearinghouse without being worked
- Write-offs and adjustments are high and no one can explain them
- You've had billing staff turnover and aren't sure what was left undone
What we look at
- A/R aging by payer and by bucket (0-30, 31-60, 61-90, 91-120, 120+)
- Unworked, rejected and unsubmitted claims
- Write-offs, adjustments and timely-filing losses
- Patient balances and point-of-service collections
- Billing vendor reports compared against your own data
What you get
- A clear picture of what's collectible and what's likely lost
- A prioritized A/R cleanup plan, starting with the largest balances
- A vendor or team performance scorecard based on your own numbers
- Recommended KPIs and reporting so it doesn't happen again
Common questions
How do I know if my billing company is doing a good job?
Compare their reports against your own data: days in A/R, denial rate, the share of A/R over 90 days and net collection rate. An independent audit does this with no stake in the answer.
Is this a coding compliance audit?
Our focus is revenue: claims, A/R and collections. If we see coding patterns that need a certified coding compliance review, we'll tell you.
Can old claims still be collected?
Often some can, depending on each payer's timely filing and appeal limits. The audit separates what's still recoverable from what isn't, so your team works the right claims first.
Related services
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