Medical Billing Audit Services
Comprehensive Medical Billing Audit Services
Trusted Medical Billing Experts
What Are Medical Billing Audits?
Medical billing audits ensure your claims and coding fully comply with healthcare regulations. Our certified auditors carefully review patient charts and billing records to confirm accuracy, identify discrepancies, and ensure all services are properly documented.
Regular audits detect errors, missed charges, and compliance issues early—helping you prevent denials, reduce penalties, and maintain a healthier revenue cycle. With SMBT, you gain confidence in precise coding, complete documentation, and optimized reimbursements.
How Does SMBT Medical Coding Audit Company Help?
SMBT provides expert medical billing audit services to ensure the accuracy and compliance of your billing and coding operations. Our detailed audits detect errors, optimize claim accuracy, and strengthen revenue integrity.
Our certified auditors review documentation and coding to uncover issues and improve efficiency, helping providers prevent denials, compliance violations, and revenue loss. With SMBT, you gain reliable protection for both financial and regulatory performance.
Medical Coding Audit
We provide thorough medical coding audits for all types of medical records, including inpatient, outpatient, professional fee (profee), and home health, ensuring accuracy and compliance across all healthcare settings.
Medical Billing Audit Services
We conduct detailed audits for all claim types, including Medicare, Medicaid, commercial insurance, and self-pay, ensuring accuracy and compliance across the board.
Government & Payor Audit
We assist providers in preparing for and responding to government and payor-mandated audits, including TPE, RAC, OIG, DMEPOS, and Medical Necessity.
Clinical Audits for Quality
We perform both internal and external clinical audits to evaluate the quality, safety, and effectiveness of your patient care and clinical outcomes.
Aging Claims Audit
Our collection aging audit helps boost your cash flow by identifying errors in aged claims and refiling denied claims for prompt resolution.
Medicare Chart Audits
We audit Medicare patient charts to ensure all billed amounts are justified and compliant, ensuring your practice receives full and fair reimbursement.
Unsure About the Quality of Your Medical Records?
Let us help you gain clarity and ensure accuracy with our expert audits!
Eliminate Errors, Maximize Revenue
Solve Your Billing Challenges with Our Auditing Solutions
The Impact of Billing Errors
Billing errors can threaten the financial stability, cash flow, profitability, and long-term sustainability of healthcare organizations.
Clean Billing Claims
Our comprehensive billing audit carefully reviews each claim for accuracy, ensuring maximum appropriate reimbursement to support the financial health and long-term stability of your healthcare organization.
99% Claim Acceptance
Using advanced NLP and machine learning, we analyze medical records to detect coding errors, optimize reimbursements, and prevent claim denials.
Compliance Issues
Non-compliance can lead to penalties, fines, audits, investigations, lawsuits, sanctions, and exclusion from federal health programs.
Meet Billing Compliance
Our advanced billing analytics engine detects trends, outliers, and red flags in real-time, enabling targeted audits to mitigate compliance risks and prevent government scrutiny.
Coding Errors
Coding errors can result in claim denials, revenue loss, overcharges, underpayments, patient dissatisfaction, and potential legal consequences.
Reimbursement Cuts
Reimbursement reductions may compel healthcare providers to cut staff, limit services, close practices, or accept fewer Medicare patients.
Maximize Reimbursements
Our AI-powered billing audit system analyzes your claims data to uncover missed revenue opportunities and compliance risks, ensuring every dollar is captured before reimbursement cuts
SMBT Auditing Solutions Overview
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Optimize Internal Workflows
Optimizing Your Medical Billing and Coding Processes
Internal Audit Services
We perform a thorough review of your internal processes and documentation to ensure they align with industry standards. Additionally, we provide actionable recommendations to help providers enhance their performance.
External Audit Services
We conduct an independent review of your claims and payments from third-party payers, such as Medicare and Medicaid. Our services include resolving billing disputes, recovering underpayments, and managing aged receivables.
Prospective Audit Services
We review your claims before submission to ensure they are accurate, complete, and compliant. Our proactive approach helps prevent denials, rejections, and delays in reimbursement.
Retrospective Audit Services
We review your claims after they’ve been processed by payers to identify any errors. Our team helps correct mistakes, appeal denials, and optimize your revenue cycle for better financial outcomes.
Comprehensive Audit Services
We offer a thorough audit of your entire medical practice, reviewing every aspect of your operations—from coding and billing to documentation and compliance—to ensure accuracy and efficiency.
Missing Revenue? We’ll Recover It.
Our expert audits thoroughly analyze your claims data and billing records to identify and recover improper payments and missed revenue opportunities.
Ensure Billing Compliance with Our Coding Audit Service
Our coding audit service ensures your medical billing remains accurate, compliant, and error-free. We identify discrepancies, reduce claim denials, and enhance your revenue integrity through detailed performance reviews.
Comprehensive Medical Billing Audits
Strengthening compliance and revenue performance.
Ensuring Accurate Coding
At our medical coding audit company, assessing coding accuracy is a key focus. We carefully review medical charts to ensure that codes accurately reflect diagnoses, procedures, and complexity levels. Proper coding is essential for correct reimbursement and compliance with guidelines. Our audits identify issues such as upcoding or undercoding and provide recommendations for correction. With our expert support, providers can be confident their coding meets industry standards and captures the full reimbursement value owed.
Enhancing Charge Capture Accuracy
Charge capture accuracy is another critical area we focus on. We ensure that all services rendered and supplies used are correctly captured in the billing at the appropriate rates. Missed charges result in lost revenue, which is why our auditors meticulously compare medical records with itemized billing statements. We identify any overlooked charges and provide recommendations to improve your charge capture processes. Our aim is to maximize your reimbursement by addressing gaps where legitimate charges may be missed.
Auditing Provider-Payer Contracts
Some other areas we examine are proper application of insurance payor contracts and fee schedules as well as accuracy of data entered into the billing system. Invalid fee schedules and data entry errors can sabotage reimbursement. We verify compliance with payer contracts and recommend process improvements to enhance billing system accuracy. Our comprehensive audits cover all key facets to maximize claim quality and revenue integrity
Auditing Billing Documentation for Compliance
A comprehensive documentation review is a key component of our billing audit process. We evaluate whether medical records provide clear and consistent documentation to support the coded claims. Complete and accurate documentation is essential to justify charges and withstand payer scrutiny. Our team identifies any documentation issues, such as vagueness, inconsistency, missing signatures or credentials, and lack of medical necessity. We offer guidance to enhance documentation practices, ensuring better claim defense and improved audit outcomes.
Are Your Claims 100% Accurate?
Ensure your practice runs smoothly with a complimentary claims audit. Discover errors, improve accuracy, and maximize revenue with our expert evaluation.