A medical billing audit can be a valuable tool in helping your eye care practice identify any problem areas and ultimately make important improvements so you can provide better patient care and achieve better revenue collection for services provided.
Let’s examine how a billing audit works and what benefits you can gain from the process.
What is a Billing Audit?
Audits focus on the effectiveness and efficiency of your claims and billing systems. They also determine whether your eye care practice is complying with insurance guidelines and government regulations.
Auditors will closely examine three main areas of your eye care practice:
- Clinical records of patient care, including lab reports and X-rays
- Billing records such as patient statements, records of payment, and insurance documentation
- Policy related documents to ensure proper compliance
How are Billing Audits Conducted?
A medical billing audit can be conducted by either a third-party provider or an internal billing department. The audit person or team will carefully examine the billing documentation to ensure that charges are correct and appropriate, that proper documentation has been kept, and that the coding and billing practices meet regulations.
The auditor will review your fee schedule to ensure that the charges match your standard medical rates. The next step is carefully examining patient records to determine if the charges are appropriate and match the service provided. The auditor will also look at whether or not the coding and billing have met industry standards.
What are the Benefits of a Billing Audit?
Regular audits are vital for the health of your eye care practice’s revenue cycle management. Here are some of the many benefits of conducting a billing audit:
- Identify problems and errors within the coding and billing process that may be causing financial losses
- Ensure accurate payments are received, which leads to an improved collection rate and better cash flow
- Stronger compliance with industry regulations, which helps mitigate fraudulent practices
- Lower outstanding accounts receivable and a higher collection rate
- Enhanced efficiency, leading to faster payments, lower administrative burdens, and better patient satisfaction
- More positive relationships with insurance providers and other third-party payers
Medical billing is a complex and ever-changing field, so it’s important to regularly conduct audits so that your eye care practice can see the financial benefits of improved accuracy and efficiency. Medical billing audits should be regularly undertaken to ensure the smooth operation of your practice.
