Safe Harbor Group’s Commitment to Your Success
Crucial elements of a practice’s compliance program include auditing and monitoring. There are many benefits to taking a closer look at your service lines. For instance, a comprehensive review of your organization’s coding and billing practices invites the opportunity to quickly identify and remedy any potential compliance issues.
Safe Harbor Group offers billing and coding auditing services to ensure you can handle future scrutiny easily and efficiently. Our team of industry-leading experts understands the importance of thorough audits to uncover unrealized coding opportunities and maximize revenue at the practice.
A billing and coding audit is a comprehensive review of a medical service encounter compared to what was submitted for reimbursement to either a government or commercial insurance payor. This systematic review is conducted to ensure accuracy, compliance with Federal and state regulations, and adherence to coding guidelines to confirm appropriate reimbursement. It also provides an opportunity to readily identify compliance risks, detect potential fraud, waste, and abuse, and take swift corrective actions. Audits are also opportunities to improve clinical documentation, update outdated Electronic Medical Record (EMR) systems, or implement safer operational procedures.
Did you know that while billing and coding audits should be performed at regular intervals as part of an entity’s compliance program, audits can also be performed for other objectives, such as due diligence in a potential merger or acquisition? It’s also important to conduct billing and coding audits when you employ a third-party billing company. Do not place your business at risk by skipping this crucial step. While it is a good idea to perform your own routine internal audits, it is recommended that you seek external assistance from an objective partner to better safeguard the practice against risk.
Billing & Coding Audit Process
The process of conducting a billing and coding audit is phased to ensure a comprehensive review of the services provided. In general, an audit consists of a review of the following:
Documentation Review
A review of the medical record documentation to verify that the services billed were provided and documented appropriately.
Coding & Billing Accuracy
An assessment of the reimbursement codes assigned to services, procedures, and diagnoses to ensure alignment with the patient’s condition and care provided.
Compliance Alignment
Assurance that billing adheres to guidelines by coding bodies and regulations set by the government and private insurers.
Risk Mitigation and Education
The audit process identifies areas where risks such as overbilling and underbilling exist and shows how to rectify them. It also provides an opportunity to discuss any discrepancies or areas for process improvement, as well as for education. Feedback from an audit can lead to noticeable improvements in accuracy and efficiency.
Six Benefits of Routine Encounter Audits
Conducting routine encounter audits are not only fulfilling a component of your compliance program, but they are also incredibly beneficial to healthcare providers for many reasons, including:
- Quality Assurance: Conducting audits confirms that documentation and coordinating billing and coding are compliant with regulatory standards
- Identified Areas of Improvement: Through the audit process, patterns or trends that indicate an opportunity for improvement can be identified
- Risk Management: Audits help address any potential legal or financial risk exposure for an organization. This proactive approach reduces any likelihood of regulatory scrutiny.
- Reimbursement Optimization: Thorough and accurate documentation provides maximum reimbursements and can reduce the amount of denied claims and potential requests for repayments.
- Collaboration: The audit process can provide opportunities for further education to occur for all staff members. The education process can fuel collaboration, sharing of insights and fostering a culture of learning and improvement within the practice.
- Enhanced Patient Care: Ultimately, by maintaining compliance, healthcare practitioners can focus on making more informed decisions and in turn, providing a higher standard of care for their patients.
Why Choose Safe Harbor Group for Billing & Coding Auditing Services in Detroit?
Safe Harbor Group provides clear, reliable support for practices in Detroit and nationwide seeking greater accuracy in their billing and coding. Our auditors bring deep clinical and regulatory insight, helping organizations identify missed opportunities, spot inconsistencies, and strengthen documentation before problems escalate.
With guidance shaped by real investigative experience and a national record of meaningful results, SHG’s team gives practices a clearer view of their coding patterns, reimbursement trends, and compliance exposure. This level of insight helps providers navigate complex requirements with greater confidence and protect their revenue from unnecessary risk.
Partner with Safe Harbor Group to Ensure Accuracy in Your Billing & Coding
As a healthcare provider, you need a partner you can trust who understands the complex arena of regulatory compliance. Our team consists of knowledgeable and experienced healthcare professionals who can provide practices of any size with the compliance assistance they need to focus on optimal patient care.
