Ensure your claims are accurate, compliant, and fully optimized. Our experts help you minimize risks, avoid penalties, and maximize reimbursements.

Discover hidden revenue leaks and billing errors that are costing your practice thousands. Our expert Healthcare Practice Audit services identify compliance issues, coding inaccuracies, and missed revenue opportunities to optimize your practice's financial health.

Book Your Free Consultation

    Clean Claims. Faster Payments. Less Stress.

    medical audit services usa

    What Is Practice Audit & Medical Billing and Coding Audit Service?

    • A practice audit, specifically a medical billing and coding audit, is a systematic and comprehensive examination of your healthcare practice's entire revenue cycle infrastructure.

    • Think of it as a financial health checkup for your practice - our certified auditors expertly review every aspect of your billing operations, from initial patient encounter documentation to final payment posting. We analyze your coding accuracy, charge capture processes, claim submission procedures, denial patterns, compliance adherence, and revenue optimization opportunities.

    • Our Practice audit team reveals hidden revenue leaks, identifies compliance vulnerabilities, and uncovers operational inefficiencies that may be silently draining your practice's profitability.

    • Don’t Wait for Compliance Warnings. Fix Errors Now.

    The Value Our Practice Audit Services Deliver

    The transformative benefits of a professional practice audit go well beyond error detection. You’ll gain:

    Compliance Protection

    With increasing government scrutiny and payer audits, our comprehensive review ensures your practice meets all CMS guidelines, HIPAA requirements, and payer-specific policies, protecting you from costly penalties and legal complications.

    Operational Efficiency

    By identifying workflow bottlenecks, documentation gaps, and process inefficiencies, we help streamline your revenue cycle, reduce claim processing time, and improve staff productivity.

    Data-Driven Insights

    Our detailed analytics provide clear visibility into your practice's financial performance, helping you make informed decisions about staffing, technology investments, and growth strategies.

    Long-Term Sustainability

    Regular audits create a culture of accuracy and compliance. We ensure your practice maintains optimal financial health and reduces the risk of future revenue disruptions.

    A practice audit is about transforming your practice into a well-oiled financial machine that maximizes every dollar earned while maintaining the highest standards of compliance and patient care.

    Health & Billing Medical Coding Audit Offers

    Precision Coding for Maximum Reimbursement

    We conduct thorough medical coding audits across all healthcare settings and record types:

    Inpatient coding: Complex hospital procedures and diagnoses

    Outpatient coding: Clinic visits, same-day procedures, and consultations

    Professional fee coding: Physician services and specialist procedures

    Home health coding: In-home medical services and equipment

    Our certified AAPC auditors ensure every code reflects the actual services provided,

    maximizing your legitimate reimbursement while maintaining compliance.

    Complete Claims Review Across All Payer Types

    Health & Billing Medical Practice Billing Audit Offers

    Don't let billing errors drain your revenue. Our comprehensive medical billing audits cover:

    • Medicare claims: Navigate complex CMS requirements and avoid costly penalties

    • Medicaid billing: State-specific compliance and documentation standards

    • Commercial insurance: Optimize payer contract terms and fee schedules

    • Self-pay accounts: Improve patient billing accuracy and collection rates

    • We identify billing discrepancies, recover lost revenue, and streamline your entire claims process.

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    Facing a government audit? Don't panic - we've got you covered!

    Government & Payor Mandated Audit Preparation

    Our expert team prepares you to confidently respond to:

    TPE (Targeted Probe and Educate) audits

    RAC (Recovery Audit Contractor) reviews

    OIG (Office of Inspector General) investigations

    DMEPOS (Durable Medical Equipment) audits

    Medical Necessity reviews and appeals

    We transform your audit anxiety into audit confidence with comprehensive preparation and expert representation.

    Health & Billing’s Practice Audit Process

    01. Comprehensive Practice Assessment01

    Our healthcare audit team conducts a thorough review of your:

    • Medical coding accuracy and compliance
    • Charge capture processes
    • Claims submission procedures
    • Documentation quality
    • Payer contract compliance
    • Revenue cycle workflows

    02. Detailed Financial Analysis02

    We analyze your practice's financial health through:

    • Year-over-year revenue comparison
    • Payer-wise reimbursement analysis
    • Denial rate assessment
    • Account receivables aging review
    • Fee schedule optimization
    • Collection efficiency evaluation

    03. Compliance & Risk Assessment03

    Our medical billing compliance audit covers:

    • CMS regulation adherence
    • HIPAA compliance verification
    • Fraud and abuse risk evaluation
    • Documentation adequacy review
    • Billing policy alignment
    • Quality assurance protocols

    04. Actionable Audit Report04

    Receive a comprehensive medical billing audit report with:

    • Detailed findings and error analysis
    • Revenue recovery opportunities
    • Compliance risk assessments
    • Process improvement recommendations
    • Implementation timeline
    • ROI projections

    Our medical practice audit services are built to safeguard your practice.

    We deliver precise and fully compliant healthcare practice audits that not only uncover risks but also ensure accurate reimbursement and strengthen your revenue cycle.

    What you'll receive:

    Complete revenue cycle analysis
    Coding accuracy assessment
    Compliance risk evaluation
    Detailed ROI projections
    Custom improvement roadmap

    Whether you’re preparing for an insurance review, assessing the performance of your coding team, or proactively improving compliance, our audits provide the clarity, confidence, and actionable insights your practice needs to stay protected and profitable.

    We Protect Your Practice, Maximize Revenue, and Ensure Compliance Through Comprehensive Audits

    Before Health & Billing

    With Health & Billing

    Claim Accuracy

    Frequent denials due to coding mistakes

    99%+ clean claims, fewer denials

    Revenue Capture

    Lost revenue from undercoding or missed charges

    Maximum reimbursement and recovered missed revenue

    Compliance Risk

    Exposure to HIPAA, ACA, and payer penalties

    Mitigated legal exposure, audit-ready documentation

    Cash Flow

    Delays from aged AR and rejected claims

    Faster payments, improved collection ratios

    Patient Billing

    Confusing statements, disputes, and dissatisfaction

    Clear, error-free statements improve patient experience

    Operational Efficiency

    Staff time spent on corrections and appeals

    Streamlined workflows, staff efficiency, and reduced errors

    Audit Preparedness

    Stressful and reactive government or payer audits

    Proactive compliance, ready for TPE, RAC, OIG, and more

    Charge Capture

    Missed services and revenue leaks

    Complete charge capture for every service rendered

    KPI Visibility

    Limited insight into billing performance

    Real-time analytics, benchmarking, and actionable reports

    FAQs

    Why should I get a medical billing audit?

    Audits help identify coding errors, missed charges, and compliance gaps that may be causing revenue loss, claim denials, or legal exposure. Early detection ensures proper reimbursements and a healthier revenue cycle.

    How do you identify revenue leakage?

    We analyze historical claims, coding patterns, denials, and documentation gaps. Using advanced auditing techniques, including AI-driven checks, we pinpoint underpayments, missed charges, and compliance risks.

    Do audits disrupt our daily operations?

    No. Our Health & Billing medical audit team works with your staff and systems efficiently, often remotely, to minimize disruption while reviewing claims, documentation, and coding practices.

    Will the audit help me prepare for government or payer reviews?

    Yes. Our audits ensure your records, claims, and processes meet regulatory requirements, so you’re fully prepared for TPE, RAC, OIG, and other audits.

    Is my patient data secure during the audit?

    Yes. We follow 100% HIPAA-compliant processes and safeguard all sensitive information. Your data is handled securely at every stage of the audit.

    How soon will I see improvements after an audit?

    You can often see immediate benefits in claim accuracy, fewer denials, and recovered revenue. Long-term improvements in cash flow and compliance are achieved as recommended changes are implemented.

    How will an audit benefit my practice?

    • Reduce claim denials and underpayments
    • Recover missed revenue
    • Prevent compliance violations and penalties
    • Strengthen your documentation and coding accuracy
    • Improve cash flow and overall financial stability

    Can you help with ongoing compliance, not just one-time audits?

    Absolutely. We provide continuous support, staff training, and periodic reviews to maintain coding accuracy, compliance, and revenue optimization long-term.

    How do I get started?

    Simply schedule a consultation with our team. We’ll review your current billing and coding processes, outline audit options, and deliver a clear plan to maximize revenue and compliance.

    Health & Billing Brings

    Hope, Health & Harmony

    To Your Healthcare Practice
    So, You can focus on what’s more important: Patient Care!

    Reduced Administrative Burden | Improved Cash Flow | 100% HIPAA-compliance
    Cost Efficiency | Certified medical coders and credentialing specialists | Scalable Solution