Medical Coding Audit Services | Healthcare Auditing Company

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Comprehensive Medical Coding Audit Services

Regular coding audit services constitute a vital component of a healthcare facility or provider’s internal compliance plan. Typically conducted annually, these audits involve random or focused sampling of data over a set period. While compliance plan-driven audits are beneficial, healthcare institutions and providers mustn’t overlook the necessity or value of additional audits.

At AnnexMed, our comprehensive coding audit services cater to all service types and specialties within healthcare settings. These audits are instrumental in mitigating coding compliance risks, reducing coding-related denials, and seizing revenue opportunities that might otherwise be missed. Our audit sample selection targets high-risk areas and identifies revenue and quality-impacting opportunities, ensuring a focused approach.

What sets our Coding audit services method apart is the thorough examination of both coding and Clinical Documentation Improvement (CDI) processes. Our team of credentialed audit experts collaborates with healthcare organizations to assess deeply, report findings, and provide essential training. Staying abreast of regulatory changes, our expert audit team ensures ongoing compliance, helping mitigate risks effectively.

AnnexMed conducts comprehensive coding audit service reviews and charge capture audits, pinpointing potential under or overbilling of services. This meticulous analysis aims to enhance overall billing accuracy and integrity, optimizing revenue streams.

Moreover, our audit reports are customizable, tailored to each client’s specific needs. These detailed reports pinpoint error trends, facilitating targeted coding staff education based on results. Our coding audit services identify performance improvement opportunities by evaluating the strengths and weaknesses of coding, documentation, billing, and reimbursement practices.

Coding Audits capabilities include:

Hospital Coding
Audits

Physician Specialty
Coding Audits

HCC
Audits

Charge
Audits

Service Highlights

Credentialed Auditors
Comprehensive audit reports
Compliant Coding Practices
Education and Training

Benefits

Reduce coding compliance risk
Prevent missed revenue opportunities
Avoid payment recoupment from external audits
Identify areas to improve clinical documentation

Achieve Measurable, Proven Results

Costs Reduced

upto

45%

Reduced operational costs

DNFB Reduced

upto

32%

Reduction in DNFB accounts

Improve Productivity

upto

72%

Productivity improvement

Reduction in AR

upto

36%

Reduction in aged A/R

Improved Collections

upto

98%

Achieve net collections

Reduce Denials

upto

72%

Decrease in denial rate

FAQs in Medical Coding Audit Services

Why are medical coding audits important for healthcare providers?

Audits improve coding accuracy, reduce claim denials, ensure compliance with payer and CMS guidelines, protect against regulatory audits, and increase revenue by correcting coding errors.

What types of medical coding audits are performed?

Common types include prospective audits (before claim submission), retrospective audits (after billing), random audits, focused audits (targeted areas), and risk-based audits (high-risk claims).

What errors do medical coding audits detect?

Audits often uncover upcoding, undercoding, incorrect modifier use, missing documentation, unbundling, and mismatches between clinical records and billed codes.

How do coding audits improve reimbursement accuracy?

By identifying and correcting coding errors before claims are submitted, audits increase clean claim rates, reduce denials, and ensure claims are paid accurately and timely.

How often should medical coding audits be done?

Most facilities perform monthly or quarterly coding audits; high-volume specialties or high-risk departments may benefit from more frequent reviews to maintain quality and compliance.

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