Medical Billing Audit ensures whether accurate medical billing is performed or not and Obliterate billing errors in claim processing.

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3. Introduction
 Medical Billing is a comprehensive and intricate process
requiring meticulous and precise handling at all level and
scope of service.
 Quality standards at each scopes needs to be assessed to
ensure they are meeting the maximum reimbursement
criteria. Medical Billing Auditing is mandate for each scope of
service for a smooth and profitable Revenue Cycle
Management.
 Understanding the importance of Medical Billing Auditing
and involving audit at the right time can save a lot of claims
from denials and revenue loss.
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4.  In this article let us discuss on the things to
know about Medical Billing Auditing to aid
improvised financial system for your Medical
Billing.
 Quality claims keeps Medical Billing revenue
flow intact, however ensuring the quality
percentage does not diminish below the
standard margin necessitates consistent and
regular audits on the below area.
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5. Medical Records
and Documentation
Claim Duplication
Coding Audit
Attention to Codes
Medical Billing
Audits
Charges and Fee
Schedule
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6. Medical Records and Documentation
 Audit the patient records for
accuracy and completeness of the
given information.
 Precise documentation is crucial for
billing and coding functions to draw
maximum collections.
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7. Coding Audit
 Irrespective of the specialty and complexity level; coding
errors are inevitable.
 Regular coding audit should be a part of your billing
process.
 Based on the error percentage and with any changes in the
coding protocol or guideline, inclusion of new coders or new
specialty can require increased attention and frequent
audits.
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8. Attention to Codes
 Verify the procedure code CPT,
diagnosis code ICD 10 CM and
modifiers are appropriate to the
given medical records.
 Coding diagnosis vs. symptoms,
primary and secondary coding
levels, code first or combo code
guidelines are few areas to be
crosschecked to ensure they are not
causing any denials.
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9. Charges and Fee Schedule
 Auditing your charge entry process
frequently should be a mandatory
process to ensure you are getting
paid as per the fee schedule.
 Being ignorant of the changes in
fee schedule and billing the claims
with the out dated value can
seriously affect your financial
system
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10. Claim Duplication
 Claim duplication can be a reason
for denials or rejections.
 Medical Billing audits should focus
on verifying claim duplications to
avoid such scenarios depreciating
possible reimbursement.
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11. Medical Billing Audits
 Unlike Medical Coding audits, Medical Billing audits can be
much more comprehensive covering complete billing scopes
of services from RCM cycle.
 Given below is the list of billing scope that needs regular
audits for cleaner claims and faster payments:
 Insurance Verification process
 Demographic Entry
 Claim submission process
 Payment Posting
 AR follow up and Denial Management
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12. Benefits of Medical Billing Auditing
 Regular audit are essential part of every Medical Billing Process
to ensure maximum benefit from business financial goals.
Medical claims auditing at various level not only captures errors
but also aids in educating the team involved in claims processing
to avoid repetition of such errors or slips.
 Medical claims audit can be internal or external, the respective
advantages from each type of Medical Claims Auditing. While
internal audits gives the coders and billers a stand to leverage on
if things did not work out, External Audits are more educative and
can help curb re-occurrence.
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13. About e-care
 E-care is one of the leading Medical Billing Companies providing
complete Revenue Cycle Management Solutions along with
Billing and Coding Audits.
 With more than 80 clients across various states in US and being a
multi-specialty billing company e-care can provide dedicated and
focused billing services to all our clients ensuring maximum
collection and reduced denial percentage.
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14. THANKS!
 To know more about e-care and its
services
 call us: 1-813-666-0028
 log on to www.ecareindia.com
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