Medical Billing Audit Services
A structured review of your billing operation that shows exactly where revenue leaks.
How AccMed RCM Handles Medical Billing Audit Services
A billing audit answers a simple question: is your practice collecting everything it has earned? AccMed RCM reviews a defined sample of your claims, remittances, and accounts receivable to find patterns: undercoded visits, charges never billed, denials written off without appeal, payments below contracted rates, and claims that aged past timely filing. Findings are reported by category and dollar impact where the data supports it, not as generic observations.
The audit covers the full cycle: charge capture, coding accuracy against documentation, claim submission timeliness, denial handling, payment posting accuracy, and A/R follow-up by aging bucket. You receive a written report with the issues found, the supporting examples, and a prioritized list of corrective actions. If you want help fixing what the audit finds, the same report becomes the work plan, but the audit itself stands on its own.
What Our Medical Billing Audit Services Cover
Claims sample review
A representative sample of paid, denied, and written-off claims is traced from charge to final resolution.
Coding accuracy check
Billed CPT and ICD-10 codes are compared with the supporting clinical documentation.
Denial pattern analysis
Denials are grouped by payer, reason, and service to reveal fixable root causes.
Payment and contract review
Posted payments are compared with contracted allowed amounts to detect systematic underpayment.
A/R aging analysis
Receivables are reviewed across the 0-30, 31-60, 61-90, and 90+ day buckets for follow-up gaps.
Timely filing review
Claims approaching or past payer filing deadlines are identified, along with proof-of-filing issues.
Findings report and action plan
You receive a written report with prioritized recommendations and the examples behind each finding.
Why Practices Choose This Service
Revenue leaks identified
Unbilled charges, unworked denials, and silent write-offs are found and quantified from your own data.
Objective outside view
An independent review catches habits and workarounds your internal team may no longer notice.
Prioritized fixes
Findings are ranked by impact and effort, so your team works the most valuable corrections first.
Better payer accountability
Documented underpayment patterns give you evidence for payer discussions and contract reviews.
Baseline for improvement
Audit metrics create a starting point against which later performance can be measured honestly.
What Our Billing Audit Reviews
Claims sample
A sample of recent claims checked from charge to payment.
Coding
CPT, ICD-10, modifiers and E/M levels compared with documentation.
Denials
Denial reasons grouped by cause, payer and provider.
A/R & payments
Aging, unworked claims and underpayments against contracts.
When to Get a Billing Audit
Collections dropped
Revenue fell while patient volume stayed the same.
How This Fits Your Revenue Cycle
Every service we offer connects to one complete billing workflow, so nothing falls between the cracks:
Insurance Eligibility & Verification
We confirm coverage and benefits before a claim is ever created.
Charge Entry & Medical Coding
Charges are captured and coded accurately with CPT and ICD-10.
Claim Scrubbing & Submission
Every claim is checked for errors, then submitted electronically.
Payment Posting
Payer payments and adjustments are posted accurately from remittance data.
Denial Management & Appeals
Denials are reviewed, corrected, and appealed where appropriate.
A/R Follow-Up
Unpaid claims are tracked and followed up until resolved.
Patient Billing
Patient statements and balances handled with clear, simple workflows.
Reporting & Analytics
Regular reports on claims, payments, denials, and A/R aging.
Medical Billing Audit Services for Every Specialty
Our workflows adapt to your specialty’s coding rules and payer requirements. See the full list on our specialties page.
Medical Billing Audit Services Questions, Answered
What access do you need to perform an audit?
We need read-only access to your practice management or billing system, plus recent remittance and A/R reports. The audit is performed under a confidentiality agreement, and all patient data is handled in line with HIPAA requirements.
How large a sample do you review?
Sample size is set with you before the audit starts and depends on claim volume and the areas of concern. We select claims across payers, providers, and outcomes so the findings reflect the whole operation, not one corner of it.
Will the audit disrupt our billing operation?
No. The review runs alongside your normal workflow using reports and system access, and your team continues billing as usual. We schedule any questions for staff in short, planned sessions.
What do we receive at the end?
A written report covering each area reviewed, the specific findings with claim examples, and a prioritized action plan. We walk through the report with you and answer questions before you decide on next steps.
Is the billing audit really free?
Yes. Our initial billing audit is free and has no obligation. It reviews a sample of your claims, denials and A/R so you can see where revenue is being lost.
What access do you need for an audit?
Usually read-only access to your practice management system or exported reports (aging, denials, payments), under a HIPAA Business Associate Agreement.
How long does an audit take?
Most small-practice audits are completed within one to two weeks after we receive access or reports.
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Start with a free billing audit — no obligation, no sales pitch.