TRANSFORM YOUR REVENUE CYCLE
Welcome to Elevate Medical Billing and Coding Forensic Audit, where precision meets profitability. Our cutting edge audit service is meticulously designed to transform your revenue cycle management (RCM) in under 30 days, driving tangible improvements in revenue, efficiency, and data utilization.
At Elevate, we understand the complexities of medical billing and coding. By scrutinizing every aspect of your billing processes, we identify opportunities for revenue enhancement and operational efficiencies. Our approach not only uncovers hidden revenue streams but also optimizes your workflow, ensuring that you’re maximizing your financial performance while maintaining compliance.
Increased Revenue
Enhanced Compliance
Grow Faster
Friendly Support
problems
Medical practices frequently face numerous challenges in billing and coding, which can impact the efficiency and effectiveness of their revenue cycle. These issues often hinder financial performance and can be difficult to identify without expert analysis.
Coding Errors and Inaccuracies
Incorrect codes can result from various factors, including lack of training, misunderstanding of coding guidelines, or simply human error. These inaccuracies can lead to claim denials, underpayments, or delayed reimbursements.
Complexity of Coding Systems
The medical coding system, which includes ICD-10, CPT, and HCPCS codes, is complex and continually evolving. Keeping up with the latest updates and changes requires continuous education and training. However, many practices lack the resources to ensure their staff are always up-to-date.
Inadequate Documentation
Accurate coding depends heavily on thorough and precise medical documentation. Inadequate or incomplete documentation can lead to incorrect coding, as coders may not have all the information needed to select the appropriate codes.
Denied and Rejected Claims
Claims can be denied or rejected for various reasons, including incorrect patient information, mismatched codes, or failure to adhere to payer-specific guidelines. Dealing with denials and rejections is time-consuming and requires a well-organized denial management process.
Insurance and Payer Challenges
Negotiating contracts with insurance payers and understanding the specific requirements of each payer can be daunting. Differences in payer policies and reimbursement rates add to the complexity, making it challenging for practices to ensure they are receiving the appropriate compensation for their services
Lack of Staff
A shortage of qualified billing and coding professionals can leave practices struggling to manage these crucial tasks effectively. Inadequate staffing can lead to burnout, increased errors, and reduced efficiency in the billing process.
OUR PROCESS
We start with a 30-day complimentary audit, focusing on the prior 6 months of your billing and coding. This is the most comprehensive analysis available today, providing a broad range of data to enhance efficiencies and increase revenue. Upon completion, we present our findings and recommendations to help optimize financial performance.
OUR SOLUTION
Our 30-day complimentary audit focuses on the prior six months of your billing and coding practices. During this period, we conduct an in-depth analysis to identify inefficiencies, errors, and missed opportunities that may be affecting your revenue cycle. Upon completion, we present detailed findings and actionable recommendations designed to increase your annual revenue by 20%.
BILLLING AUDIT
- Patient records
- Billing codes
- Claims submissions
- Reimbursements
- Patient billing
- Payment posting
- Appeals
- Compliance
- Internal controls
- Financial reports
- And more
CONTRACT(S) REVIEW
Provides insight into the terms and conditions of agreements with insurance companies. This analysis helps practices maximize revenue, ensure compliance, and streamline operations.
IN-DEPTH ANALYSIS
CODING AUDIT
- Code Assignment
- Documentation
- Upcoding
- Claim Form
- Payer compliance
- Special services
- Internal coding
- Denials & Rejections
- Fraud detection
- Financial Impact
- And more
INSURANCE PAYER UNDERPAYMENTS
This can occur due to incorrect application of contract terms, payer errors, or misunderstandings of the contract's provisions. By identifying these discrepancies, practices can pursue the appropriate reimbursements
TARGETED RECOMMENDATIONS
20% ANNUAL REVENUE INCREASE
Our audit produces actionable data by examining medical billing and coding practices to uncover inaccuracies, inefficiencies, and opportunities for improvement. This data helps improve coding accuracy, enhance documentation, and maximize reimbursements. It also offers insights into payer compliance and denial trends, allowing practices to streamline processes and boost revenue. Our targeted recommendations will include a detailed ROI analysis and a plan to significantly increase your annual revenue.
