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Medical Auditing

WCH Service Bureau

According to the U.S. Department of Health & Human Services, 42 percent
of claims are coded incorrectly.

Medical Auditing
WCH Service Bureau
Clarity
Working with credentialing payers, WCH supports absolute transparency of credentialing process for providers
We are able to provide a client with statuses for all the opened processes online, 24 hours per day. By request, we also gladly send credentialing reports including all the details and proof of pending or approved cases.
WCH Service Bureau
Comfort
WCH presents results in a timely manner
We are familiar with State Laws and Insurance Regulations. Due to long-term on the job relationships with numerous insurances, we quickly achieve positive results, and our connections are getting stronger as the years pass.
WCH Service Bureau
Security
WCH keeps all the records of providers safe
During and after credentialing process, we keep our client's information as non-disclosed for the third parties.
Medical Auditing
Oksana Pokoeva
Oksana Pokoyeva
Account Representative, CUC, COC, CPMA, CPC-P, CPCO, CPC
  • Experience
    Experience: Professional and successful work since 2001;
  • Safety
    Safety: Certified professional auditors. Work with lawyers. Go to courts.
  • Professionalism
    Professionalism: National industry recognition and certifications from AAPC, AMBA, AHIMA, HBMA, HCCA, PAHCOM, BBB and OIG, OMIG compliant;
  • Education
    Education: Extensive education for your staff;
  • Valuables
    Valuables:
    • Readiness for insurance companies’ audit;
    • Increase revenue. Eliminate unpredictable penalties.
  • Result
    Result Full report with proof, valid for insurance audits;
  • Approach
    Approach: Review, Identify, Analyze
  • Fees
    Fees: Professional Fees: $ 120.00 per hour. A detailed invoice will be provided at the time the review is complete.
WCH Contacts
Tel.: (718) 934-6714 ext 1241
Ready to start?
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Auditing Service Documents
Pdf file AUDITING SERVICE AGREEMENT

Our areas
of expertise includes:

All Services
WCH Service Bureau Audiology
WCH Service Bureau Cardiology
WCH Service Bureau Chiropractic
WCH Service Bureau Dermathology
WCH Service Bureau IDTF
WCH Service Bureau Internal Medicine
WCH Service Bureau Mental health
WCH Service Bureau Neurology
WCH Service Bureau Physical Therapy,
Occupational Therapy
WCH Service Bureau Podiatry
WCH Service Bureau Radiology
WCH Service Bureau Surgery
WCH Service Bureau Medical necessity
WCH Service Bureau Denied claims
WCH Service Bureau Bundling issues
WCH Service Bureau Charge captures
WCH Service Bureau Accuracy of medical coding for diagnoses, procedures
WCH Service Bureau Patterns
Our Guarantee:
WCH SERvice Bureau
Maintaining all HIPAA and Security Regulations.
WCH SERvice Bureau
Sensitivity in regards to the regulations that affect the medical and legal industry. Identifying areas of risk in conjunction with Healthcare Laws and Regulations.
WCH SERvice Bureau
Analyzing that you are fully compliant with HIPAA, State, and Federal Regulations in your business operations.
WCH SERvice Bureau
Ensuring that your business is entirely protected.
Frequently Asked Questions
Question
  • plus minus
    Why do I need an Audit?
    With today's ever-changing regulations and high frequency of audits from governmental and other healthcare payers, the internal Audit is the 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.
  • plus minus
    What is included into the WCH Auditing Services?
    Auditing Services as per Client's request may include the following:
    • Identification areas of risk leading to upcoding or downcoding in the documentation and medical coding accuracy;
    • 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;
    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.
  • plus minus
    What is the fee for Auditing Services?
    The professional fee for Auditing Services is $ 350.00 per hour. The Auditing Services Agreement includes a retainer fee of $1,000. A detailed invoice is being provided at the time the review is completed.
Second Opinion Audit

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. In fact, 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 leaving many thousands of revenue dollars on the table 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.

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 for 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.

How does this Benefit our Practice?

An expert second opinion will ensure you are maximizing revenue and minimizing common mistakes that could result in suspension of insurances or a medical license.

WCH Service Bureau

U.S. medical practices forfeit nearly $125 billion annually due to inadequate
billing practices.

WCH Service Bureau

Why WCH?

WCH reviews and processes tens of thousands of Medicare, Medicaid and private insurance claims every year. We know that billers without APPC and HBMA certifications frequently make mistakes due to lack of knowledge or carelessness that deprive providers of income because we see it every day.

Take advantage of our expertise and Get a WCH Second Opinion to ensure your in-house or other billing service is complying with changing rules and regulations and receiving maximum reimbursements. We will pinpoint deficiencies, recommend solutions, or confirm everything is on track.

Realize Your Practice Potential
WCH professionals have been providing medical billing, reimbursement analysis, chart reviews and audits
for all types of practices, large and small, for more than 15 years. To find out more about our services:
Call 888-924-3973 or
send us an email
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Wch SErvice Bureau

Medical billing services offered by WCH Service Bureau go far beyond the usual understanding of billing.

 

What we offer is not just excellent professional billing and collection services. We also stand as guardians of your reimbursement and compliance with federal, state laws and regulations as well as private insurance policies and procedures.

 

Do it right! Do it with WCH!

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Wch SErvice Bureau

Periodic medical chart auditing is vital for any healthcare provider and medical practice. Let the professionals evaluate your coding, billing, and documentation practices! Our auditors are AAPC-qualified CPMAs (Certified Professional Auditors) and CPCs (Certified Professional Coders). We perform comprehensive Chart Auditing. We can do the following services for you:

  • Identify areas of risk leading to upcoding or downcoding and medical coding accuracy;
  • Ensure that coding practices are compliant with the regulations set forth by private and government payers;
  • Evaluate Incident to guidelines and services performed on collaborative premises;
  • Perform Analysis of Denials/Duplicate billing /Appeal process/Modifier usage;
  • Review Front Desk work including but not limited to: Eligibility verification/Benefit maximums verification/Excluded services verification/Authorization process/Patient responsibility (deductibles, copays, coinsurance)/Coordination of benefits;
  • Evaluate Insurance plans participation and consistency of contracted rates;

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