Most of the time, practices lose revenue from the errors that don’t even get flagged, not from the obvious failures. Missing modifiers, documentation gaps, and undercoded E/M visits are going unnoticed. However with medical billing audit services from MedCare MSO, you get a certified audit team that reviews every code, claim, and clinical note with a clear recovery plan to recover lost revenue and close compliance gaps.
MedCare MSO uses AI technology to cross check of your billing processes and recover lost revenue.
A medical billing audit is an in depth analysis of your billing processes unlike the surface-level reporting that identifies the basic mistakes. You need a medical billing audit service like ours to discover missed charges, documentation gaps, miscoded claims and denial patterns that are there without you knowing.
These type of errors or mistakes quietly costs your practice revenue and keep on compounding over time. Upon acting on the findings of an audit, you get cleaner codes, better documentation standards, and billing workflows that result in consistent, clean claim rates, shorter AR cycles, and stronger payer compliance.
To learn more about our services, please fill out the form below and we will be happy to get back to you.
MedCare MSO’s billing audit services cover every step of the revenue cycle. Our framework includes cross-checking claims, payer guidelines, and federal regulations to check errors, gap and revenue lost.
Our certified coders review every ICD-10 code, CPT code, HCPCS code, and modifier against your clinical documentation. This audit is to identify any undercoding, upcoding, and unbundling. We also verify E/M level assignment and payer specific rules to ensure accuracy.
In our compliance audit, we review your adherence to HIPAA, CMS requirements, OIG guidelines, and payers’ contractual obligations. This step is crucial for your practice as not being compliant isn’t always known to practices and it compounds the problems over time.
Medicaid, Medicare, and commercial payers operate by their own rules and need things done their way. That’s why we benchmark your reimbursement performance against your payer guidelines to identify where you are losing revenue and get you paid for the rendered services.
Our analysts review your aging AR to identify non-collected revenue in denied, underpaid, and unworked claims. They quantify recoverable balances across every AR bucket which also includes claims age beyond 120 days, and proritize recovery plan for the account recievables.
Documentation is as important as coding. Your clinical notes must be precise and support every claim billed. Our documentation audit will flag any gaps in medical necessity documentation to make sure that payers don’t deny payments or initiate post-payment recoupment.
Denial makes an audit mandatory for any practice, regardless of size. We conduct this audit by identifying patterns rather than just analyzing denied claims. We expose the systematic denial triggers which include coding errors, payer rule misalignment, and documentation gaps, to stop denials.
Our audits aren’t done completely manually. Yes, we put in place professionals for every process but Maximus, our medical billing software is doing most of the part. It has the ability to cross-reference claims, codes, and documentation against CMS guidelines, payer contracts, and benchmarks in real time.
Our medical billing audit company offers specialty-specific audit services for practices of every size.
To explore the spectrum of our specialties, please click the button below.
I highly recommend MedCare MSO if you are looking for help with your billing and gain some freedom to see more patients or manage your business.
Practice Owner, TXEC
MedCare MSO has been an excellent organization to work with, I highly recommend them for their quality of service and commitment to excellence.
Back Office Manager, STST
We are definitely impressed by the Team’s performance. I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Director of Corporate Development, SC & SF
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Owner, R.D.
MedCare MSO did a great job with our billing and helping clean up old AR. Regular updates and good communication were very appreciated.
Co-Owner, PCP
Chief Operating Officer, MAKO MEDICAL LABORATORIES
Chief Executive Officer, CARE NOW CLINIC
Chief Operations Officer, ION DIAGNOSTICS
Co-Founder, AW Care
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
Practice Owner, F&A Clinic
We have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage.
President/CEO, RLT
I am impressed with MedCare MSO’s promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases.
Practice Owner/FBH
A coding or compliance audit takes around one or two weeks at max and during the audit, the billing cycle doesn’t stop. As for the end-to-end revenue cycle audit, it takes roughly a month, depending on the claim volume and the scope defined during the initial scoping process.
Yes, Everything we do, data collection, storage, and communication, falls strictly under HIPAA compliance standards. We execute a Business Associate Agreement with every client before we access or review any billing or patient data.
We need your patient records, coding logs, EOBs, claim submission, payment posting reports, remittance data, and payer contracts for an audit.
A medical billing audit identifies the root cause behind denial patterns and compliance gaps. The audit can be of a single or complete billing process and prevents denials from happening or recovers from what’s already lost.
A prospective audit is to prevent errors before submission, and a retrospective audit reviews the ones after they are denied. For most practices, it’s better to do both medical audits and get an idea where they stand in billing efficiency and compliance.
Please provide the following information, so our team can connect with you within 12 hours.
Or call us as 800-640-6409
TXEC
I have worked with MedCare MSO for the past eight months, and it has been a great experience. Moses, Mark, Travis, Sebastian, and Tammy have been a pleasure to work with, as well as the rest of the team, including the credentialing folks.
I highly recommend this group and MedCare MSO if you are looking for help with your billing. They will meet with you once a week to review the issues that need to be fixed to improve your payment and capture rate.
If you are looking for help with your billing and gain some freedom to see more patients or manage your business, this is the team you need to work with.
Dr. Jose Correa
Practice Owner
TXEC
STST
MedCare MSO has been an excellent organization to work with. Mark has consistently demonstrated outstanding attention to detail, thorough documentation, and strong professionalism in maintaining accurate records of his findings.
His reliability and dedication have contributed greatly to a positive experience.
I highly recommend MedCare MSO for their quality of service and commitment to excellence. I can’t say enough good things about Mark and his company.
Thank you
Shaunna Mock
Back Office Manager
STST
SC & SF
Hi Ali, I hope this message finds you well. I wanted to give you some feedback on the team.
We are definitely impressed by the Team’s performance. Definitely what we were looking for from switching partners.
In particular Mark Zaiden has been very helpful. In my 5+ years of experience as a M&A Professional, I worked with a lot of different folks from all over the world on different business transactions, and Mark is truly a top notch talent!
Austin has done a great job of leading the communications process and keeping the train going in the right direction. Tammy and some other folks have been key players as well. We really are happy with everyone on the team.
I wanted to pass this feedback along to you as we are really pleased with working with MedCare MSO so far.
Have a great weekend!
Max Owens
Director of Corporate Development
SC & SF
R.D.
MedCare MSO’s exceptional communication and expertise elevated our RCM experience and my bank accounts!
Most helpful is the open/responsive communication of their team with my office and each other, along with the specialty levels of expertise amongst my team for each aspect of RCM.
Kelly Ballou
Owner
R.D.
F&A Clinic
Working with MedCare MSO has been a game-changer for my practice. Their expertise in medical billing, AR management, and coding has significantly streamlined our revenue cycle, reduced claim denials, and improved cash flow. The team is proactive, detail-oriented, and always available to address my concerns.
I would like to take time to recognize two members of MedCare MSO specifically. Moses for his exceptional support and dedication. He is always responsive, and knowledgeable, and goes above and beyond to ensure smooth operations. His professionalism and commitment make a huge difference in our day-to-day workflow. George also for his quick feedback and recognition of what is needed most. He is extremely efficient and always available for clarification and to share his knowledge and expertise.
I highly recommend MedCare MSO to any healthcare provider looking for a reliable and efficient billing partner.
RLT
Hello,
I am writing this email to express our appreciation of the MedCare MSO’s team and all they have done for our business at RLT. In the past year, we have experienced tremendous improvements within our billing and claims department that we have entrusted MedCare MSO to manage. We went from having over $100k in uncollected/billed claims to now reaching near $100k in collection some months.
We are also happy to express our thankfulness that MedCare MSO is now helping us acquire new contracts with different insurance companies. This will in effect benefit everyone involved, allowing us to expand our services and provide more resources for our staff/business partners.
Please note special appreciation for the following:
David Lucas
Mario Ortega
Ambrose William
FBH
I have been a customer of MedCare MSO for one year. They have provided billing and credentialing services for my private behavioral health practice, and I am impressed with their promptness to respond to any inquiries, with the time they dedicate to reviewing each one of the cases, and with their willingness to educate me and my staff about the ever-changing rules of medical billing and the best use of coding. This is a company I Trust with my billing needs.
Dr. Neufeld
Practice Owner
FBH
