MEDICAL CHART AUDITING
Get paid for all your services through a preventive screening of your billing practice
MORE THAN
0 40
AUDITS
PER YEARMORE THAN
0 40
AUDITS
PER YEARClarity
Stay a few steps ahead with our comprehensive support. We are with you every step of the way, managing denials, rejections, and appeals. Let us handle these tasks, freeing up your valuable time
Comfort
Our providers enjoy 24/7 online transparency in their processes. Detailed reports and proof of pending or approved cases are are readily available upon request at any time
Security
Rest assured, we are the shield for your medical practice, ensuring strict confidentiality with third parties. With our commitment to HIPAA compliance, your data is securely stored in a protected environment
Our Guarantee:
Maintaining all HIPAA and Security Regulations.
Sensitivity regarding the regulations that affect the medical
and legal industry. Identifying areas of risk in conjunction with
Healthcare Laws and Regulations.
Analyzing that you are fully compliant with HIPAA, State, and
Federal Regulations in your business operations.
Ensuring that your business is entirely protected.
Our areas of expertise:
Audiology
Dermatology
Mental health
Podiatry
Medical necessity
Charge captures
Cardiology
IDTF
Neurology
Radiology
Denied claims
Accuracy of medical coding
for diagnoses, procedures
Chiropractic
Internal Medicine
Physical Therapy
Occupational Therapy
Surgery
Bundling issues
Patterns
Reasons to Choose Us
We have a team of highly skilled and experienced auditors who are well-versed in all areas of medical auditing.
We provide comprehensive auditing services that include risk assessment, compliance review, and process improvement.
We have a proven track record of success in providing audit services to a variety of medical organizations.
We provide personalized services to each of our clients to ensure that their individual needs are met.
We use the latest auditing technologies and techniques to ensure accuracy and reliability.
We offer competitive rates and flexible payment options to make our services more accessible to all clients.
FAQ
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Why do I need an Audit?
With today's ever-changing regulations and high frequency of audits from the government and other healthcare payers, the internal Audit is a vital process that every practice must undergo. It is recommended that medical practices conduct internal Audits at least annually to confirm compliance with the coding guidelines and documentation requirements. Protect your practice. Accurate coding and compliance with documentation requirements and healthcare payers' guidelines directly affect your practice's income. -
What Auditing Services are included in WCH's offerings?
Auditing Services as per the Client's request may include the following:
• Identification of areas of risk leading to upcoding or downcoding in the documentation and medical coding accuracy;After the completion of the audit service, we provide a written report to the Client, setting out the findings, recommendations, and audit opinion arising from the Audit.
• Verification that coding practices are compliant with the regulations set forth by private and government payers;
• Education of providers and staff on how to use documentation to maintain HIPAA compliance;
• Complete Chart Audit;
• EMR Coding/Documentation Review;
• Review compliance with the Incident to guidelines and services performed on collaborative premises;
• Analysis of Denials/Duplicate billing /Appeal process (Pre-payment and Post-payment)/Modifier usage;
• Review of format and content of the health record as well as other forms of medical/clinical documentation;
• Coding, including ICD-10-CM, CPT, HCPCS;
• Analysis of billed claims, including the UB-04, the HCFA 1500, charging procedures;
• Review compliance with the State and federal regulations concerning the use, disclosure, and confidentiality of all patient records;
• Front Desk work review including but not limited to: Eligibility verification/Benefit maximums verification/Excluded services verification/Authorization process/Patient responsibility (deductibles, copays, coinsurance)/Coordination of benefits;
• Verification if any abusive billing or fraud exists;
• Insurance plans participation and consistency of contracted rates;
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How Much Are Medical Record Auditing Services?
WCH believes in conducting business with transparency and integrity. As such, our medical record auditing services do not include any hidden fees or unexpected upcharges. However, due to the nature of massive medical record reviews, the exact cost of each audit will vary.
The professional fee for auditing services is $120.00 per hour. As part of WCH’s Auditing Services Agreement, a retainer fee of $1,000 is required. The billable hours are deducted from the retainer fee until it is exhausted.
You will be provided with a detailed invoice at the conclusion of the audit, which will outline all billable hours and your remaining balance.
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Can I Audit Both Outside Billers and Internal Management?
Every medical practice should be auditing its billing practices annually. Coding errors, inadequate record keeping, incomplete submissions, and illegal shortcuts leave a practice vulnerable to an insurance audit. Make sure everyone involved with billing, both internal staff and outside vendors, is staying up-to-date, keeping comprehensive records and complying with the latest rules and regulations for each insurer.
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What is a Second Opinion Audit?
Want to make sure that you are paid what you deserve? If so, WCH can help with that, too, with our Second Opinion Audit.
Now, there's an easy way to find out. Get a WCH Second Opinion.
This fast and low-cost verification process can quickly verify any billing-related deficiencies, provide recommendations on a potential improvement, or confirm that you are completely on the same page with the best reimbursement practices. Here is how We Can Help you make a good fortune with your medical billing:
Review of posted paid claims for accuracy
Review of partially paid claims
Review of denied claims and reasons
Review of claims affected by a multi-procedure reduction
Review of frequency of claims resubmission
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Should I get a Second Opinion on My Billing for Profitability, Protection, and Peace of Mind?
Are you confident your staff or billing service is capturing 100% of your reimbursements? Probably not. Practices lose up to 66% of their revenue annually due to coding and billing errors.
Now, there's an easy way to find out. Get a WCH Second Opinion.
WCH Second Opinion Internal Billing Audit Service is a quick and low-cost verification process that immediately identifies coding errors, recordkeeping issues, and potential liabilities. Most importantly, WCH Second Opinion pays for itself by uncovering missed revenue opportunities. -
Will A Second Opinion Help Increase Practice Revenue?
If your claims are being denied, you could be losing out on thousands of dollars in revenue every year. A WCH Second Opinion helps multi-location, multi-specialty practices and single-office providers analyze billing practices, identify errors, and make changes to regain revenue.
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How does this Benefit our Practice?
An expert second opinion will help you maximize revenue and minimize common mistakes that could lead to insurance suspension or a medical license suspension.
We specialize in providing top-notch medical billing and credentialing services, along with advanced software solutions. With our comprehensive offerings, we aim to ensure that you have access to the finest medical billing and credentialing services available in the industry. Our dedicated team of experts will guide you through every step of the process, from system configuration to efficient management of billing and credentialing tasks. Experience the difference with our exceptional services and solutions, designed to optimize your operations and maximize your success. Start your journey with us today and discover the best in medical billing and credentialing services.
AUDITING SERVICE AGREEMENT
