Medical Billing Audit Services That Trace Claims End To End.
An audit should show you where revenue is being lost and what to fix first. We trace a sample of your claims from the schedule to the payment, sort every problem by cause and owner, and give you a written report, an action plan and a findings call.
- Free billing audit
- BAA before any patient-data access
- Keep your existing EHR
Fictional examples of the format. Not client findings.
OneBill RCM Audit TeamTraces each claim
We Follow Each Claim From Start To Finish.
Instead of reviewing reports in isolation, we take a sample of claims across your payers, providers and recent months, and trace each one through every step.
- 1ScheduleWas the visit captured?
- 2Front EndEligibility, authorization, demographics
- 3NoteDoes documentation support the codes?
- 4ClaimCodes, modifiers, edits, timing
- 5RemittancePaid, adjusted or denied, and why
- 6Follow-upWas every denial worked?
Every Denial, Sorted By Cause.
Payer reason codes tell us why each claim was denied. Grouping them shows which fixes would prevent the most denials.
Coverage ended, wrong member ID, wrong primary payer
Approval missing, expired or for a different service
Diagnosis does not support the service, code-pair edits
Claim or appeal sent after the payer's deadline
Service already paid or included in another
Records, attachments or corrected claims requested
Five Areas, Specific Questions.
- Do CPT and ICD-10 codes match the notes?
- Are modifiers used where documentation supports them?
- Are services under- or over-coded?
- Is eligibility checked before each visit?
- Are authorizations on file and matching?
- How long do charges wait to be entered?
- How many claims are rejected or denied, and why?
- Are denials worked, appealed or written off?
- Are corrected claims sent correctly?
- Are payments and adjustments posted accurately?
- How is A/R spread across 30, 60, 90 and 120 days?
- Are secondary claims and patient balances billed?
- What is the net collection rate?
- Where are the recovery opportunities?
- Which fixes come first?
This is an operational billing review. It is not a legal compliance audit or legal advice; if we see a compliance concern, we tell you so you can involve your advisers.
A Report You Can Act On Monday.
Each finding names the area, what we saw, why it matters, the fix and who owns it: your front desk, your clinicians or your billing team. You keep the report whether or not you work with us.
Any estimated financial impact is an estimate, not a promise of future collections.
Findings by area, with examples and the evidence behind each one.
Priorities in order, each with an owner.
We walk through the report and agree next steps.
Days, Not Months.
Your practice, systems, concerns and the audit terms.
Signed and approved before we see patient data.
Typically three business days once records and access are ready; usually within a working week.
You decide whether to onboard. Onboarding takes a further three to five business days.
Questions Before You Book.
How Many Claims Do You Review?
A sample across your payers, providers and recent months, sized to your volume. We agree on the scope on the discovery call.
Does The Audit Fix The Problems?
The audit gives findings and recommendations. Corrections, appeals and recovery happen through the service you agree with us, or your own team.
Do We Have To Switch Our EHR?
No. We review access and workflow requirements with you.
Is There A Cost?
No. The billing audit is free. We explain how it works on the discovery call, before the audit begins.
See Your Billing Clearly Before You Decide.
Tell us about your practice and where billing feels stuck. We explain the audit terms on your discovery call, before the audit begins.
- Free billing audit
- BAA signed before any patient-data access
- A written report, an action plan and a findings call