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98% Accuracy Rate

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99% Claim Acceptance Rate

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96% First Time Pass Rate (FTPR)

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Days in Account Receivable (DAR) 19

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86% Collection Rate Within the First 30 Days

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12 Years of Excellence

Do you find yourself in a predicament where your collections are dropping or your reimbursements are unexpected? If so, our medical billing audit service will determine these issues, improve your revenue cycle and ensure you receive what you deserve.

Is your practice’s cash flow being affected by rising denial rates? Our audit services will root out the causes and improve claim acceptance to optimize your revenue cycle.

Are you worn out from handling dispute letters from insurance companies or threats of audit? Our practice audit guides you through those complexities while making sure you play by the rules and cutting back on financial risks.

Notice a drop in numbers of patients despite your hard work? Our medical billing audit will help uncover undisclosed factors that affect your medical billing processes increasing your patient base.

Do you have problems with the visibility of financial conditions in your business? Our audit services give distinct revelations meant for improving your financial management and operational efficiency.

Concerned about differences which may exist between your EMR collections and bank statements? We provide professional audit services that will make sure reconciliation of these disparities is done, hence maintain accurate financial records as well as peace of mind.

Get Started with Pyramids Global
Your Trusted Medical Billing Solutions Provider

Why Audit Is Important

Ensure Financial Health and Decision-Making

It is important to understand your practice’s financial status. Our medical billing audit will give you the insights you need to make informed decisions and making sure your practice will continue to thrive and grows sustainability.

Achieve Billing and Coding Compliance

Stay compliant with our comprehensive billing and coding audits. We assist you in managing complex rules while minimizing the chances of making costly mistakes so that your organization meets all essential guidelines.

Identify and Improve Billing Processes

Streamline your billing operations with our expert audits. We reveal those areas for you to work on increasing efficiency, ultimately saving time and cash thus improving your overall practice performance.

Guarantee Timely Claim Submissions

Our medical billing audit services enable you to avoid potential losses. We ensure that 100% of claims are submitted on schedule. Thus, there is no revenue that you miss which results into your cash flow problems being addressed promptly through this action.

Payment Integrity

Medical Billing Audit Services: Achieving Excellence, Ensuring Integrity

Our medical billing audit offers a detailed check-up of your practice’s financial activities. It helps spot any possible problems with how you get paid, deal with denied claims, and stick to billing rules. We look at more than 50+ variables and compare your results to what’s common in the industry. This gives you a clear view of your financial health over the years.

During the audit, we closely examine how your billing team handles their tasks, including how accurately they code, prevent denials and submit claims. We check if the services you bill match the services you have scheduled. This helps us find any missed opportunities at the front desk that could increase overall collections. Our report will highlight areas where your billing processes could improve and suggest ways to make things more efficient, ensuring claims are submitted correctly and on time for maximum reimbursement.

Our findings offer practical insights to fix any lags in your current methods, boosting how well your practice operates and its financial stability. This in-depth analysis is key to making informed decisions that push your practice toward optimal financial results and compliance.

Premium Medical Billing Audit Report: Improving Financial Accuracy and Boosting Revenue

Our medical billing audit report provides in-depth critical financial details necessary to keep your practice running smoothly and to improve how you manage your billing procedures. The primary goal of our medical billing audit is to identify potential areas of error and verify the appropriateness of your billing practices.

Discrepancies in billing and coding can lead to significant revenue leakage and if these are not fixed, it can result in business instability. Our report gives you a high-level summary of the audits we performed at your medical practice and highlights key findings that can help you make strategic improvements.

Payment Integrity
Payment Integrity

Evaluating the Accuracy and Efficiency of Medical Billing Practices

Our medical billing audit services monitor the accuracy and efficiency of your billing process. We examine each payment invoice, whether paid or denied, to spot any mistakes in how services were coded.

Additionally, our comprehensive report gives you a clear picture of the financial situation in your business. It identifies problems such as processing delays, payment mistakes and errors in cash flow management. The report also highlights issues like differences in fee schedules, charges that haven’t been billed, discrepancies in payment posting and the overall financial well-being of your practice.

Enhancing Claim Processing, Compliance, and Financial Health with Strategic Medical Billing Audit

Our medical billing audit provides you with valuable information that pinpoint improvement opportunities for efficient claim processing and enhancing the reimbursement workflow. This report also helps you avoid compliance issues and fraudulent billing activities, such as over-coding or under-coding. We take a closer look at how you are currently handling payments and offer practical advice or actionable strategies on how to fix problems that could be causing revenue leakages.

Payment Integrity

Empower your practice and prepare for the future at every level!
Book your free consultation today for a medical billing audit.

To better understand your financial health and how well your operations are going, we focus on a few key areas:

  • Revenue Analysis: We keep a close eye on the amount of money you bring in each month and year. This includes analyzing your actual billings to insurance companies and patients. It helps us to see how well your payment processes are working.
  • Accounts Receivable Management: We analyze pending accounts. This includes the money insurance companies and patients have to contribute. Understanding this helps us determine how quickly you get paid and how well you manage this accumulation.
  • Operational Metrics: Key operational metrics include:
  • Days in Accounts Receivable (DAR): This figure tells us the average number of days it takes to get paid after an invoice or bill.
  • First Time Pass Rate (FTPR): This percentage indicates the number of times your claims are paid on the first submission without problems, which reflects the accuracy of your initial claims process.
  • Claim Submission Volumes: We look at the number of claims you submit over time (monthly or annually). This allows us to monitor your workload and the effectiveness of your operations.
  • Patient and Service Volume: We see how many patients you see and how often, which gives us insight into your level of service and patient engagement. We also look at issues with contract fees, as these can have a significant impact on your bottom line.

Analyzing these areas gives us a clearer picture of where you stand financially and what can be improved.

Enhance Payment Rates

Our complete review of your revenue cycle management ensures that your practice maintains optimal billing compliance and identifies potential inefficiencies within your billing processes. Here is what we focus on.

  • Billing Compliance: We monitor how well your medical practice is following payment rules to help keep everything running smoothly.
  • Process Efficiency: Here we will identify any delays or potential slowdowns in your payment process.
  • Claims Management: Dealing with pending claims resulting from insufficient information. We also highlight missed, unsubmitted, or undercharged claims.
  • Error Analysis: We check for errors in the handling of claims, whether charge entries, coding procedures or submission to the clearinghouse.
  • Financial Health Checks: We analyze your billing process and patient pending balances to help improve financial outcomes.
  • Credentialing Review: We thoroughly review your credentials and enrollment with major insurers to ensure you meet their standards and secure your provider status.

This comprehensive analysis helps ensure that your medical practice is up-to-date and financially sound.

Navigating Telemedicine Credentialing Requirements and Processes 3

When we look at your medical bills, we see more than just mistakes. We offer a comprehensive program designed to improve your financial health and the day-to-day operations of your practice. Here is what we focus on.

  • Coding Compliance
  • Accounts Receivable Optimization
  • Revenue Cycle Management Enhancements
  • Provider Documentation and Data Reporting Improvements
Deciphering J-Codes in Medical Billing for Healthcare Professionals 1

Our comprehensive audit process ensures transparency and integrity from start to finish:

  • Data Acquisition
  • Data Aggregation
  • Detailed Financial Review
  • Audit Findings
  • Final Report Delivery
Medical Credentialing

Your Audit Report Partner

Consider us your partner in the world of medical billing. We are here to do more than just identify faults, we aim to equip your practice with the skills needed to make sustainable and effective improvements. Our ultimate goal is to make your billing processes more accurate and efficient, helping you increase revenue and ensure compliance.

Services That Fix What the Audit Finds

An audit shows where revenue is leaking. Pyramids Global can then fix each issue with:

Medical Billing Audit FAQs

What does a medical billing audit review?

Pyramids Global’s Premium Practice Audit reviews your coding accuracy, claim denial patterns, accounts receivable aging, payment posting, payer-specific compliance, and underpaid claims to show where your practice is losing revenue.

Is the audit free?

Yes. Pyramids Global offers a free practice audit, so you can see the findings before deciding whether to outsource any part of your billing.

Do we have to switch billing companies to get an audit?

No. The audit is a review of your current billing performance. You can use the findings with your in-house team, your current billing company, or Pyramids Global.

How often should a practice audit its billing?

Most practices benefit from a billing audit at least once a year, and again after major changes such as new providers, a new EHR, new payer contracts, or a sudden rise in denials.

What happens after the audit?

You receive a clear summary of the issues found and the steps to fix them. Most practices see measurable improvement within 60 to 90 days once those issues are addressed.

Is our patient data protected during the audit?

Yes. Pyramids Global follows HIPAA-compliant workflows and signs a Business Associate Agreement with every client practice before reviewing any patient data.

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