Conduct systematic Medical Billing Performance Audits to keep your Medical Practice Healthy!

What is a medical billing performance audit and why is it important?

You travel to work daily and every day your car’s engine makes strange noise. A day comes when it finally stops working. If you had the car diagnosed, the issue could have been fixed before becoming a problem. Same goes for a business, no matter what industry.

A medical practice has many moving parts. Issues can arise in workflows, billing, or systems.. To avoid these menial issues becoming major problems, systematic performance audits are important.

A medical billing audit identifies issues in practice management workflows and billing processes. Audits can be internal or external.

What is assessed in a Medical Billing Audit?

A Medical Billing audit focuses on gaps in workflows and processes. Have a look at the points below to get a detailed idea of what the audit should cover:

  • Revenue Integrity and lost opportunity cost
  • Provider and staff inefficiencies
  • Workflows and process improvements
  • Revenue cycle management performance
  • Insurance contracts and fee schedules
  • Compliance documentations

A medical billing audit covers all claim life cycle phases. Through this, the areas that require improvement are highlighted. Audits protect practices from losses and fraud.

How can a Medical Practice Conduct Self Medical Billing Performance Audit?

Track KPIs monthly and yearly to identify issues. KPIs improve performance and benchmark against industry standards.

Establish consistent metrics for easy analysis and gap identification.

What key RCM indicators should Medical Practices be tracking?

  • Monthly charges, payments, and adjustments compared to averages and historical data
  • Charge-entry lag times
  • Denial percentage
  • Clean-claim-rate percentage
  • AR aging by date of service
  • Gross-collection percentage
  • Net-collection percentage
  • Days in AR/Days in AR over 120 Days

A Medical Billing Audit identifies issues and provides a roadmap for improvement. It helps Practice Managers answer questions like:

  • Why isn’t my Practice making more money than it is?
  • Do we have more no-shows than other practices?
  • What processes need to be more effective?
  • Are Patients paying their deductibles and co-pays in timely manner?

How can AltuMED help?

AltuMED is an experienced Medical Billing and Practice Management Company that provide its Medical Practices with systematic and effective Medical Billing Performance Audits. We believe in working with our practices to fulfill our aim of providing “value for all” in terms of healthcare as well as monetary benefits. Contact us to book yourself a Performance Audit straight away.

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