You cannot fix what you cannot see. A medical billing audit shows exactly where your practice is losing revenue — under-coded visits, unworked denials, missed charges, aging A/R — and where your coding could create compliance risk. Medical Coder's medical billing audit services give you a clear, prioritized action plan.
What Our Medical Billing Audit Covers
Coding and documentation audit
Certified coders review a sample of encounters against documentation: E/M level selection, CPT and ICD-10 accuracy, modifier use (such as 25 and 59) and medical necessity. We flag both under-coding (lost revenue) and over-coding (audit risk).
Denial and rejection analysis
We break down your denials by reason, payer and provider to show which problems cost the most and how to prevent them. See our denial management services.
Accounts receivable review
We review A/R aging by payer, identify claims that are still recoverable, and flag balances at risk of timely-filing write-offs.
Charge capture and fee schedule review
We check for services performed but never billed, and compare your fee schedule with your payer reimbursements.
Front-end process review
Eligibility checks, authorizations and patient data entry cause a large share of denials. We review how your front desk handles them.
What You Receive
- A written audit report with findings by category
- An estimate of recoverable revenue
- Coding accuracy findings with examples
- A prioritized list of fixes — what to do first and why
- A walkthrough call to explain the results
When Should a Practice Get a Billing Audit?
- Collections dropped without a drop in patient volume
- Denials or A/R over 90 days keep rising
- You changed billing staff, software or billing company
- You are adding providers or a new specialty
- You want a compliance check before a payer audit
Billing Audits for Texas Practices
For Texas practices we also check payer-specific issues: Texas Medicaid (TMHP) filing and managed care authorization rules, Novitas Medicare edits and commercial prompt-pay underpayments. See our Texas medical billing services.
Start With a Free Initial Audit
We offer a free initial review of your claims, denials and A/R. If you decide to outsource, see medical billing for small practices and our pricing. Request your free audit.