Billing Integrity Audits

Have you been audited by Medicare, BCBS, or any commercial payors?  Are you concerned about billing and coding practices or wondering if all charges were captured and billing accurately?

One of the many services Legacy Consulting provides is a Billing Integrity Audit. There are several layers to this kind of audit and we can provide all or just some of the pieces, depending on our client’s needs. These audits can prove useful to assure compliance and ensure your practice is being reimbursed properly for its services.

  • Every practice needs and confirmation that they are billing and coding correctly and compliantly– both for clinical reasons and reimbursement reasons. Our team can take a selection of charts per payor and per provider and do a thorough audit of each chart to confirm the proper documentation, correct coding, and appropriate billing levels were sent out on each claim.
  • Along with the documentation, we will review billing and coding to ensure your practice received the maximum reimbursement allowed, based on the clinical documentation. We will identify any gaps with modifiers, CPT codes or diagnosis codes, particularly with ICD-10, and ensure the appropriate billing levels were sent out on each claim.
  • We then provide an assessment of where we see deficiencies or areas of concern. We provide a suggested action plan and are available to help carry out any of the steps along the way with our Medical Billing Services. We also look at potential underpayments, overpayments, fee schedule discrepancies, EOB Reviews and provide ICD-10 training if needed as well.

Legacy Consulting Services can assist your practice by ensuring the claims that go out the door are correct and no money is being left on the table.

Contact us today to have us help your practice realize its collection potential!

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