Medical Auditing Services

Guard Profits, Reduce Errors

Wouldn’t it be great if you had the ability to maintain the highest level of compliance while actually increasing your reimbursement rates?

You can with our comprehensive auditing service.

Under The Affordable Care Act, providers need to perform self-audits, compliance checks, and other additional research to identify and return overpayments. The Center for Medicare & Medicaid Services (CMS) is classifying over payments and the failure to return the overpayment within 60 days of identification as a false claim. The penalty of a false claim is not less than $5,000 and not more than $10,000 per overpayment, plus three times the amount of the overpayment.

The purpose of the RAC Audit program is to identify improper payments made to healthcare providers for services rendered to Medicare beneficiaries.

Recovery Audit Contractors are performing RAC Audits all over the country. They have identified and recovered hundreds of millions of dollars.

In addition to the RAC Audits, CMS is tasked with enforcing the Medicaid Integrity Program (MIP). One of CMS’ responsibilities under the MIP program is to hire contractors to perform Medicaid Integrity Contract (MIC) audits.

Based on the above and best practice, now more than ever self-audits are a necessity in order to avoid potential heavy penalties levied by CMS and Medicaid.

Our certified coders will provide a thorough review of your coding, billing, and reimbursement processes. We can identify areas of risk for your practice and even provide training for documentation techniques that could improve your workflow.

Once the audit is performed, you’ll be given a detailed report and a consultation with an audit specialist. We go beyond a simple error report and actually recommend corrective actions. We provide support and training to implement the audit solutions.

• Protect Against RAC Audits and MIC Audits
• Identify Charting Errors
• Stop Under Billing
• Improve Reimbursement
• Detailed Reports
• Personal, Expert Review
• Implement Corrective Actions