1. Compliance Audit Services
Running your own practice means you are your own boss and your own staff. You are the go-to person for all your staff members to reach out to when they have any problems. Not just that, you also have to stay on top of the billing, claims submission, and revenue cycle management processes to ensure that your practice is being reimbursed for the services provided.
However, all of this interferes with your ability to see patients and give them your undivided attention. But if you are not managing it all with a fine-tooth comb, there will be quite a few inaccuracies and mistakes that will arise during the claim filing process, resulting in denials and late payments. One of the ways to prevent this is to perform a medical billing audit, but that only adds to your responsibilities. There is, however, a simple solution to this. You can benefit from the compliance audit services offered by Practolytics by outsourcing medical billing audits.
What is a Medical Billing Audit?
A medical billing audit is a thorough process of evaluating each claim by examining all attached documents and coding for a specific patient. The main purpose of the audit is to analyze where the inaccuracies and mistakes are, that are resulting in denials, and avoiding them going forward. If you have found your practice facing multiple denials that you just cannot figure out the reason for, then a medical billing audit may be needed.
A medical billing audit also looks at the compliance issues at your practice, such as compliance with coding guidelines and a documentation protocol. The most common reasons for denials are inaccurate patient information, lack of patient eligibility, and inaccurate coding; all of which are highlighted during a medical billing audit and a compliance audit.
Why are Medical Billing Audits Important?
Medical billing audits are good for your practice, especially when performed regularly. While they are mostly performed to assess the inaccuracies in the claim filing process, it is recommended to perform them regularly. This way, errors during the claim filing process can be corrected in real-time, rather than figuring them out after a claim has already been denied.
The audits also take a closer look at the documentation methods and billing protocols, aiming to ensure that all medical records are documented accurately for the right patient. This, in turn, helps with eligibility checks for each patient at your practice, making it less likely for the claim to be denied due to patient eligibility issues.
Medical billing audits not only determine where the issues are arising from but also give insights into how these issues can be solved. After a medical billing audit is performed, a detailed report is constructed that highlights the issues and their root causes and gives you the idea of how to fix those issues and avoid them in the future.
Benefits of Outsourcing Compliance Audit Services
Medical billing audit is a crucial part of running a successful practice that is free of coding errors and claim denials. However, these audits can significantly increase the burden on your staff and you, taking away the time you would be spending with your patients and providing medical care.
This is why it is recommended to outsource medical billing audits to a vendor with compliance audit services, such as Practolytics. This helps reduce the pressure on your staff so that they are much more welcoming and relaxed to the new patients. Similarly, you can spend more time focused on your patient's health rather than worrying about the audits, denials, coding errors, and other documentation issues.
Why Choose Practolytics’ Compliance Audit services
Practolytics is a compliance audit service provider that takes over the billing process and assesses any inaccuracies and how to rectify them. The compliance audit services ensure reduced denials for your practice and code compliance for the current and future claim filing submissions.
Objective Point of View
While outsourcing is mostly recommended to reduce the stress on you and your administrative staff, it can also help provide a new look into the audit process and the control points that are being considered. Before you perform an audit, you need to determine specific control points. Outsourcing allows you to receive an objective, third-party view of the audit process and whether or not the control points are appropriate for the issues your practice is facing.
Chart Analysis
Some of the features that your practice will benefit from when you partner with Practolytics are a detailed analysis of all charts and claims to ensure that accurate patient information has been captured and proper coding has been done.
Compliance Evaluation
Another aspect of the medical billing audit by Practolytics is code compliance meaning that they evaluate all claims, previous and current, to determine if the coding is up to date based on current guidelines and protocols. More often than not, the reason behind a denial is coding errors or lack of compliance with the guidelines, both of which are included in the audit services by Practolytics.
Practolytics also checks for compliance with vendors’ documentation meaning that if a specific document by a vendor has expired or updated to include new information and guidelines, then the guidelines will be automatically updated in your system as well, to avoid compliance issues going forward. This feature of compliance audit services by Practolytics makes them so attractive to private practices since it takes your practice away from the concept of a yearly audit. Instead, there is a continuous compliance check to ensure the issues highlighted in the audit aren’t repeated.
Detailed Reports
After performing the audit, Practolytics prepares a detailed report for your practice to keep you in the loop and update you on the findings of the audit. When thinking of outsourcing the audit process to a vendor, it is important to look for vendors that provide you full access to your own data. This may seem trivial, but in most cases, vendors and practices like yours have an incompatibility of software, resulting in a clear lack of shared data.
Practolytics prepare reports on coding compliance, billing errors, and patient filling and documentation errors to inform you of where the critical weak points are. These reports not only analyze the issues in the practice but also point at the root cause, meaning that you know how to fix these issues.
