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Quality Assurance

Great Quality Audits equals better results which leads to higher yield

 

 

Consistent review of your Revenue Cycle Process

A revenue cycle management audit is an organized evaluation of compliance and quality at a healthcare facility. Every aspect of running a medical practice is included in the audit process, but the most significant component in the revenue cycle audit is the process leading to reimbursement. Every step leading to billing a claim is looked into for compliance with the federal and state guidelines, along with the regulations of the private insurance companies.

Revenue Cycle Audits aims to survive the ongoing scrutiny by insurance contractors and federal auditors. Implementing scheduled audits at the healthcare facility is the best defence against federal and insurance company audits. Any questionable billing patterns can be identified by auditing the claim data and generate risk reports so that healthcare facilities can identify their compliance oversights. Otherwise, such errors can cost heavily to the physician in terms of federal prosecution, monetary penalties, criminal penalties, exclusion from insurance networks and demands on payback of reimbursements.

Expectations from the revenue cycle audit are to ensure good quality patient care at the facilities and providers are educated on documentation on guidelines. A successful audit checklist can completely screen the revenue cycle management at the facility and optimize it to make sure appropriate payment is received per treatment. It also empowers you to defend against malpractice litigations, health plan denials and audits from the state and private insurance companies.

Innovative Healthcare Solutions can help you in identifying the specific scope of an audit, use the appropriate tools to performs the audit, adhere to a medical billing audit checklist, report the findings of the audit and provide ideas to correct the errors and educate the staff. By conducting a successful audit, the auditors at Practolytics can help you resolve an ongoing non-compliant billing process at the facility. This would enable you and your team to safeguard your patients, receive the appropriate reimbursements and avoid risking payment litigations.

Be Compliant in All phases of the Revenue Cycle

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