Reimbursement Audits
Contact Us
Find Revenue You Did Not Know Was Missing
Medical Billing Management Services Inc. provides reimbursement audits for medical practices in Hanford, California.
Your practice in Hanford may be losing revenue without realizing it because of undercoded procedures, missed charges, or billing workflows that allow certain services to go unbilled entirely. These gaps are common in busy practices where staff is focused on patient care and assumes that everything billable is being captured and submitted correctly.
Medical Billing Management Services Inc. conducts reimbursement audits by reviewing your billing procedures to identify missing potential revenue and confirm that you are receiving maximum reimbursement for the services you provide. You receive a detailed report showing where charges were missed, where codes could be optimized, and where payer contracts may be underpaying your practice.
If your practice in Hanford wants to know whether you are being reimbursed fully for the work you do, learn more about reimbursement audits and what they include.
What Gets Reviewed During a Reimbursement Audit
A reimbursement audit starts by reviewing several months of billing data from your practice in Hanford, including submitted claims, payments received, codes used, and documentation attached to each encounter. Medical Billing Management Services Inc. compares what was billed to what could have been billed based on the services documented in patient charts.
You will see a list of procedures that were undercoded or not billed at all, along with an estimate of the revenue your practice missed during the audit period. You also receive recommendations for changing your billing workflows so these issues do not continue.
This service includes identifying payer contract terms that may be outdated or incorrect, reviewing modifier usage, and checking whether your practice is capturing all billable time for procedures that involve multiple steps. It does not include legal advice or contract negotiation, but it does show you where to focus your attention to recover lost revenue.
Some Things You Probably Want to Know
Most practices want to understand what kind of issues typically show up during an audit and how long it takes to complete the review and receive results.
What kind of billing errors do reimbursement audits usually find?
Common issues include procedures that were documented but never billed, codes that were downgraded when a higher-level code was supported, and missed charges for supplies or additional time spent with patients. Medical Billing Management Services Inc. reviews your records to find these patterns.
How long does a reimbursement audit take?
Most audits are completed within two to three weeks, depending on the size of your practice in Hanford and the number of months being reviewed. You receive a full report once the audit is finished.
What happens after the audit is completed?
You receive a written report that lists the issues found, estimates the revenue lost, and includes recommendations for changing your billing procedures. Medical Billing Management Services Inc. can also help you implement those changes if you choose to continue working together.
Can an audit help if my practice is already using a billing service?
Yes. Even practices that outsource billing can benefit from an independent audit to confirm that nothing is being missed and that your current service is following best practices. You may find that certain services are not being billed correctly or that your contract terms need updating.
How much missing revenue do most practices find?
It varies, but many practices in Hanford recover several thousand dollars per month once they correct the issues identified in an audit. The exact amount depends on your specialty, patient volume, and how long the issues have been occurring.