Medical practices must place strong emphasis on the accuracy of their billing, and whether or not their billing practices are code-compliant. Without these two qualities, no medical facility will be able to operate properly. To ensure that your medical facility is following the best billing practices, you’ll want to carry out a medical billing audit. These are some of the questions people may ask regarding a medical billing audit.
Who Performs the Medical Billing Audit?
There are many people who can carry out a medical billing audit. Sometimes, it’s done by staff who are within your medical practice. Other times, these audits will be outsourced to an auditing firm, or automated with technology platforms that are built to handle auditing processes. Which option you pick will depend on your practice’s available resources, specific needs, and how much auditing experience your staff has.
How Often Should a Medical Billing Audit Be Done?
Not all medical practices will perform audits at the same rate. This will depend on your practice’s size, how many claims you receive, as well as regulatory requirements. As an example, larger practices that work with many different payers while also employing in-house billing staff might perform audits biannually because of how complicated claim processing can get. Smaller practices that don’t have as many billing staff members might conduct a medical billing audit once per year instead of twice.
What Can Happen When a Medical Billing Audit Isn’t Completed?
When you don’t perform a medical billing audit, there can be many consequences that your medical practice faces. To start, your practice may be unable to detect fraudulent practices or errors in billing and coding procedures. These problems can cause your practice to lose money, impacting your facility’s ability to operate.
Not performing billing audits also puts your practice at risk for getting external audits from payers or government agencies. These audits take a lot of time and resources, and you might even face penalties in a worst-case situation.
Your medical practice can also have its reputation damaged when you don’t get medical billing audits done. As we mentioned before, it can be harder to detect bad billing practices, or errors in billing and coding procedures. These types of issues can make patients lose trust in your medical facility.
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