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MEDICAL BILLING & CODING AUDIT SERVICES

AboutBe On The Same Page with Your Payers & Patients!

You work hard to provide quality care to your patients, but are you getting paid what you deserve? Errors in medical billing means lost revenue, denied claims, and legal troubles. Therefore, medical billing audit services by a medical coding audit company become a necessity.

Prime Billing offers healthcare coding and compliance audit services for healthcare providers. Our experienced billing auditors review a provider’s billing codes for accuracy, compliance, and optimization with real-time issue resolution. So don’t put your practice at risk. Get in touch with us today and let us help you meet medical billing compliance.
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Happy Customers
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Completed Cases

Schedule Free Audit Consultation

    WHY IS IT?

    What are Medical Billing Audits?

    Medical billing and coding audits are necessary checkups to ensure a provider’s billing claims and coding documentation meet medical billing compliance. Certified billing auditors inspect patient charts and billing records to guarantee the use of correct codes that match conditions and care. Like routine physicals catching health problems early, audits diagnose issues in billing, allowing providers to correct course.

    Audits are important as they reveal improper coding, incomplete documentation, missed charges, and noncompliance with reimbursement guidelines. This helps strengthen a provider’s revenue cycle by correcting errors proactively before they can lead to denied claims or penalties for incorrect billing. Regular comprehensive audits are advantageous as they ensure proper coding, completeness of records, optimal reimbursement, compliance with payer policies, and overall financial health.

    How does Prime Billing Medical Coding Audit Company help?

    Prime Billing works as a professional medical billing audit services company. Medical billing and coding is complex work full of pitfalls for error, calling for vigilant oversight. Therefore, our medical coding audit and compliance services provide this monitoring, serving as a safety net that preserves the integrity of the entire medical claims billing process.



    The experienced billing auditors at Prime Billing, take a magnifying glass to documentation, coding choices, and the submitted claims to unveil inaccuracies and illuminate opportunities for billing cycle improvement. Our findings steer healthcare facilities toward error-free medical coding and full revenue capture.



    Just as crucial, our high quality medical billing audit program heads off billing compliance violations and fraud that lead to fines, penalties and damaged integrity. Our audit service is thus a fundamental pillar upholding clinical, financial, and regulatory excellence.

    Check our Medical Billing Audit Solutions

    Medical Coding Audit

    We do medical coding audits for all types of medical records, including inpatient, outpatient, profee, and home health.

    Medical Billing Audit

    We do medical billing audits for all types of claims, including Medicare, Medicaid, commercial, and self-pay.

    Government & Payor Mandated Audit

    We prepare providers for and respond to government and payor mandated audits, such as TPE, RAC, OIG, DMEPOS, and Medical Necessity.

    Clinical Audits

    We conduct internal and external clinical audits to assess the quality and safety of your patient care and clinical outcomes.

    Collection Aging Audit

    We improve your cash flow by auditing your aged claims for errors and refiling denied claims with our collection aging audit.

    Auditing Medicare Patient Charts

    We audit Medicare patient charts, ensuring every dollar billed is justified and compliant, so your practice gets fully and fairly paid.

    WHAT DO WE OFFER

    Your Billing Problems & Our Auditing Solutions

    Inaccurate billing and coding practices cost medical practices big. Denied claims lead to lost revenue. Backlogs lead to cash crunches. Errors lead to audits and penalties. Our medical billing and coding audit service sheds light on what’s broken in your workflows. After a comprehensive analysis of your people, processes and technology, we deliver specific recommendations to maintain compliance for a better-functioning revenue cycle.



    1) Billing Errors

    • Affect the financial stability, cash flow, profitability, and sustainability of the healthcare organization.

    2) Clean Billing Claims

    • With our comprehensive billing audit, we thoroughly examine each claim to verify correctness, securing maximum appropriate reimbursement to maintain financial health and endurance of your healthcare institution.

    3) Coding Errors

    • Lead to claim denials, loss of revenue, overcharges, underpayments, patient dissatisfaction, and legal actions.



    4) 99% Claim Acceptance

    • We deploy advanced NLP and machine learning techniques to analyze medical records and catch coding mistakes, optimizing reimbursement and circumventing claim denials down the line.

    5) Compliance Issues

    • Result in penalties, fines, audits, investigations, lawsuits, sanctions, and exclusion from federal health programs.

    6) Meet Billing Compliance

    • Our robust billing analytics engine identifies trends, outliers and red flags in real-time, allowing for targeted audits to eliminate compliance risks and avoid government scrutiny.

    7) Reimbursement Cuts

    • Could force healthcare providers to reduce staff, limit services, close practices, or accept fewer Medicare patients.

    8) Maximum Reimbursements

    • Our proprietary AI-powered billing audit system analyzes your claims data to identify missed revenue opportunities and compliance risks, ensuring every penny is captured before reimbursement cuts hit your bottom line.
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    Happy Clients

    We Optimize Your Medical Billing & Coding Processes

    Healthcare providers turn to Prime Billing for medical billing consulting mastery. Our consultancy helps clients gain control of their revenue cycle management, including patient billing, collections, denials management, and accounts receivable. Prime Billing guides you to revenue growth through its customized consulting services.

    We conduct an in-depth review of your internal processes and documentation to ensure that they meet the industry standards. We also provide recommendations to help providers improve their performance.
    We perform an independent assessment of your claims and payments from third-party payers like Medicare and Medicaid. We resolve billing disputes, recover underpayments, and work with aged receivables.
    We evaluate your claims before they are submitted to the payers, to ensure that they are accurate, complete, and compliant. We help you prevent any denials, rejections, or delays in reimbursement.
    We analyze your claims after they have been processed by the payers, to identify any errors. We help you correct any mistakes, appeal any denials, and optimize your revenue cycle.

    We provide a holistic approach to auditing your entire medical practice. We examine all aspects of your operations, from coding and billing to documentation and compliance.

    Medical Chart Reviews & Validations

    Prime Billing has certified doctors, auditors, and clinicians who can perform various types of reviews on your medical charts
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    Happy Customers
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    Completed Cases
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    Medical Chart Reviews

    Our clinical auditors performs various types of medical chart reviews, such as inpatient, outpatient, radiology, DME audit, mammography audit, etc. We assess the quality of the care provided, the compliance with the coding and documentation standards, and the adherence to the clinical guidelines.

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    Risk Adjustment Data Validation

    We can verify the accuracy of your risk adjustment data, such as diagnosis codes, hierarchical condition categories (HCCs), and risk scores. This can help you optimize your reimbursement, avoid penalties, and improve patient outcomes.

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    Data Abstraction Review

    We extract and abstract relevant data from your medial charts, such as diagnosis, procedures, medications, lab results, and quality measures. We also verify the accuracy of data entry in your EHR or other systems.

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    Charge Validation

    We review your charge capture process to ensure the charges billed to the payers are accurate and supported by the documentation in the medical chart. We also identify and resolve any undercharges or overcharges that may affect your revenue cycle.

    Are your Claim Submissions Accurate?

    Let us do a free health check for your practice.

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      Contact Info

      Office Address

      30 N Gould St #39988 Sheridan, WY 82801

      Cell Phone

      732-466-2541

      Email Us

      sales@theprimebilling.com