Audit
What is Audit?
A medical billing and coding audit is a multi-dimensional tool available to healthcare providers. Where it observes how effective and reliable the current billing process and documentation is, it also evaluates the accuracy of the medical coding in use. Moreover, it approximates the difference between the billed and the actual reimbursements for a healthcare provider. A billing audit that finds the difference to be close to zero means that
How We Audit:
At Gem Billing, we audit your current billing in a standard manner. Our audits are performed with the following steps:
- We use Aging Buckets method to audit medical billing
- Randomly pick claims from each AR bucket: 0-30, 31-60, 61-90, 91-120, 121-150, 151+
- Each bucket is represented in a percentage form of the total AR
- A good performing billing is represented by a heavier %weight of newer ARs and a lighter %weight of older AR
- Inefficient billing is represented by older AR weighing more in percentage
- The coding for these claims is also evaluated when they are picked out
The Aging Buckets method is a great tool to analyze the effectiveness of a billing department because it quickly yet efficiently evaluates if a billing department is inefficient in collecting ARs. Accounts Receivable are the biggest challenge in the Revenue Cycle Management and even the top performing billing companies cannot collect 100% of the ARs.
Presentation:
We present our audit results with visual data and graphs to our biller while also giving the analysis of individual claims for each bucket. An efficient audit is not only that which uses the data meaningfully and calculates the results efficiently, but also it needs to make the results easily readable and understandable.
Audit Today with Gem Billing
We understand that as a healthcare provider, your time is precious. You want to automate your medical billing process to a point that all you’ll ever need to do is go through your reports once a month and compare it with your revenue. At Gem Billing, our goal is exactly that: to take care of everything so you don’t have to worry about anything.
It’s not an easy decision to make to suddenly change your revenue cycle management provider. An audit gives you a valid reason to nullify your billing contract with your current biller. It is also healthy for your business to have an audit once a year so you can stay in loop about how efficient your biller is.
Our Audit pricing is following:
- 0.5% of monthly collections or $299 (whichever is higher) normally
- $0.00 IF you decide to start your billing with Gem Billing
