In-Depth Medical Coding Audits
Healthcare audits don’t have to be scary.
A well-planned audit is vital to medical coding optimization and makes reimbursement simpler.
Comprehensive Auditing Strategies for Multi-Level Coding
Accurate medical coding and billing are vital to revenue cycle management. Inaccuracies and omissions in the medical record lead to inefficiencies in the health system that negatively impact your organization’s ability to pursue reimbursement from health insurance companies, which frustrates your cash flow. Every health facility should have an experienced coding staff to oversee their health and human service processes and ensure they have the appropriate policies and procedures to deliver care services accurately and efficiently.
Horizon Healthcare RCM understands that maintaining high-quality medical coding is challenging when you run a busy practice. Our experienced coders can step in and help you define a strategy to improve your medical coding and billing processes. When we carry out an audit, we uncover issues holding back your revenue cycle management and reimbursement efforts. We apply our extensive knowledge to improve your accountability and accuracy.
A well-implemented medical coding audit helps you address:
- Incomplete documentation
- Processing errors
- Outdated coding
- Issues with medical necessity
Deliver Quality Patient Care With Our Scalable Solutions
Supporting patients with high-quality care services is easier with a solid technology backbone. Horizon Healthcare RCM has partnered with industry-leading software providers to deliver detailed documentation and performance reports to enhance your revenue cycle management.
How Our Audits Promote Medical Coding Optimization
Horizon Healthcare RCM has a highly-skilled and trained team of medical coders with the experience and resources to perform regular coding audits with accuracy and productivity. We explore your operations and thoroughly evaluate the reliability and effectiveness of your medical coding and billing procedures. We collect health care records and policy-related documentation, apply our processes to correct issues, and bring your diagnosis codes and procedures up to date.
Our medical coding audits help you prevent lost revenue and much more. Our solutions support:
- Department of Health compliance
- Clinical documentation accuracy
- Coder confidence and development
- Consistency in information
Prevent Fraud and Increase Compliance
Improper payments due to billing errors or fraudulent activity put your practice at risk. Billing issues upset your cash flow and disturb your reimbursement strategy. Horizon Healthcare RCM’s medical coding audits uncover improper billing practices and help you introduce new solutions to update your billing protocol and train your staff to prevent future errors.
We can help you address:
- Unintentional fraud (up-coding, unnecessary billing, etc.)
- Outdated billing processes
- Issues with accounts receivable conversion
- Lack of documentation
- Insufficient medical necessity
Protect Your Revenue Stream
Improper medical coding jeopardizes your revenue stream. Without a solid medical coding and billing strategy, you may experience more denied claims from payers. Because a rejected or denied claim can occur for many reasons, it’s essential to tackle quality assurance at a large scale to catch the issue or issues as soon as possible.
Horizon Healthcare RCM’s skilled coders evaluate your medical coding system to eliminate inefficiencies and save you the time and money it would cost to catch an issue, resubmit a claim, and finally receive reimbursement. We help you meet compliance, reduce the chances of future errors, and avoid the regulatory fines that follow improper revenue cycle management.
The Benefits of an External Healthcare Audit Defense Strategy
Health care providers can be selected for a routine medical coding audit by the Department of Health and Human Services, Medicare, or a state licensing agency at any time. Conducting regular external medical coding audits of your own is an excellent way to ensure your medical records and revenue cycle management is in order.
Horizon Healthcare RCM’s qualified coding auditors can evaluate your medical coding and billing processes ahead of time to ensure compliance and reduce the issues a state-mandated auditing team may discover. We help you secure revenue accurately and consistently and protect your practice from fraud risk. With our team on your side, you’re never surprised—we keep you trained and armed with accurate records and up-to-date regulations.
Communicate With Insurance Companies Confidently
Horizon Healthcare RCM helps medical facilities uncover insurance hidden or unknown coverages to prepare you for the reimbursement process.
