Medical Audit smart-admin August 26, 2024

Medical Audit Services
Be On The Same Page with Your Payers & Patients!

You put in a lot of effort to give great care to your patients, but are you getting the payment you deserve? Mistakes in medical billing can lead to lost revenue, denied claims, and legal issues. That’s why using medical audit services is so important.

Smart Health provides coding and compliance audit services for healthcare providers. Our skilled auditors check your billing codes for accuracy, compliance, and efficiency and resolve any issues in real time. Don’t put your practice at risk—contact us today to ensure your medical billing is compliant.

Why Choose Us?

Smart Health Medical Audit Protects You from Major Risks

Smart Health is a professional medical billing audit services company. Given the complexity and risk of errors in medical billing and coding, our audit and compliance services provide essential oversight, acting as a safeguard for the billing process.

Our skilled auditors carefully examine documentation, coding choices, and submitted claims to identify inaccuracies and find ways to improve the billing cycle. This helps healthcare facilities achieve accurate coding and maximize revenue.

Additionally, our top-notch audit program helps prevent billing compliance violations and fraud, avoiding fines, penalties, and damage to your reputation. Our service is a key part of maintaining clinical, financial, and regulatory excellence.

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Our Coding Audit Services Promise Billing Compliance: Here's How?

Charge Capture Analysis Report

This report reviews your charge capture process to find where you might be losing revenue. We look into front-end issues that cause missed charges and lost income.

Coding Audit Report

Our audit reviews a sample of charts to spot coding errors and areas for improvement. The audit report includes details on coding accuracy rates, the impact of errors and any education needed for coders.

Revenue Cycle Performance

How do your KPIs compare? Our benchmarking report compares your metrics to industry averages, helping you identify areas for improvement. We look at key indicators like first-pass resolution, A/R days and more.

Smart Health Medical Audit
Medical Chart Reviews and Validations
Smart Health has certified doctors, auditors, and clinicians who can conduct various reviews of your medical charts. These include assessments to ensure data quality and compliance, covering different types of reviews to thoroughly check your medical records.

Our Medical Billing Audit Solutions

Medical Coding Audit

We do medical coding audits for all types of medical records, including inpatient, outpatient 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

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 Charts

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

Your Billing Problems and Our Auditing Solutions

Billing Errors

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

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.

Coding Errors

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

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.

Compliance Issues

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

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.

Reimbursement Cuts

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

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.

Billing by the Numbers
+ Satisfied Providers
+ Coding Errors Resolved
K+ Audits Performed
$
M Lost Revenue Recovered