Why Audits are important for Medical Practice?

No two medical specialties are for the same diseases. They can be interlinked but not the same. Take, for example, oncology or gastroenterology. When such is the case, then there billing and coding should be different as well. Specialty specific billing requires medical billers and coders holding proficiency in these fields. If you have an inhouse team that performs generic medical billing and closing, we would suggest you outsource oncology medical billing company like Medicine.


Because accurate medical billing and coding are necessary for ensuring the robust financial health of your oncology practice. 

Outsourced oncology medical billing and coding have professionals, holding certificates and experience of having successfully helped oncology practice accelerate their cash flow by minimizing claim denials and streamlining the revenue cycle.

One function that contributes towards a smooth RCM is periodic audits. 

Audits are necessary to keep a check on the process, workflow, and identify loopholes and work on filling them. Audits can prove beneficial in surfacing the issues that are leading to medical billing and coding errors. 

Audits are also necessary to ensure that every process being performed is compliant, and there are no hurdles in the way of obtaining timely reimbursement. We all know not adhering to the standards and protocols can make the healthcare organization liable to pay a hefty fine or permanent shut down if the gravity of the breach is severe such as exposing patient healthcare records. 

When done adequately, a medical coding audit surfaces the problems clogging the revenue cycle and coming in the way of ensuring the strong financial health of the facility. 

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Another major issue plaguing the healthcare industry for decades is billing fraud. It can be intentional or unintentional. Some of the common causes of improper billing, which leads to billing fraud, are improper coding, lack of knowledge of documentation handling. This can further lead to the hospital either getting under billed or overlooked for the treatment they have rendered. 

Periodic audits can help reveal these faulty spots, which can be worked on with compliant strategies and timely holding training sessions for the in-house staff, keeping them updated on the latest tool and technology so that the claim is submitted in one go. 

The regular audit makes the staff accountable for their actions as it increases transparency with every session. Document this audit to check which department is responsible for your facility’s revenue cycle going haywire. 

To ensure that the claim gets submitted in one go and there are no chances of any denials or rejection, accuracy is pivotal. Accuracy is not important in regards to the reimbursement but enhancing the overall quality of the care and treatment with correct patient health-related documents. Audits help identify the reason behind lagging accuracy, which could be poor documentation, which reflects on the coding and further impact the treatment rendered and the clogged account receivables. 

There are many reasons which could be contributing to your degrading bottom lines, such as inaccurate coding, lack of qualified resources, poor knowledge of tools, and technology. The audit will help bring there to surface so that the needful can be done. For the lack of qualified resources, we would recommend outsourcing to a proficient oncology billing company that will assign a dedicated team of certified specialty-specific billers and coders to transform the revenue cycle and protect the bottom line from further damage. 

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Lack of education, improper communication are other such non-tangible aspects that can profoundly affect the financial health of oncology practice. Auditing will help bring to surface and bridge the gap to ensure accurate and efficient processing. 

A detailed analysis conducted by third party auditors will also help reveal the areas where you might have allocated extra resources. This will help you contain the cost of operation and invest that money in the goal of delivering quality care and treatment. 

The quality of patient care is what keeps a facility running. There are many hurdles coming in the way of you and your staff trying to deliver at par service such as the front desk mismanagement, long waiting time. Auditing will help identify the problem areas which can either be fixed internally or better still, outsourced to ensure your in-house staff has more time on their hand, tending to patients and not typing or documenting data. If they struggle in managing hours between the keypad and the patient, mistakes are bound to happen: either a patient life will be at risk due to improper treatment or your facility’s financial health will suffer due to inaccuracies. 

It is important to keep in mind that while periodic auditing is necessary, you will get constructive feedback only from professionals who will conduct thorough auditing of your facility’s revenue cycle. Burdening your inhouse team is only going to worsen the situation, defeating the purpose. This is why we suggest you consult a third-party audit service provider for your oncology practice.

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And for your billing and coding, you can place your trust in one of the leading oncology medical billing company, Medhine for its 100%accuracy and reimbursement in the shortest turn around time. 

They are offering a 30-day free trial service without any obligation to sign up a long term contract.

Reach out to Medphine’s representatives today! 

James is a blogger who loves to explore new things. His passion for helping people in all aspects of daily things flows through in the respected industries coverage he provides.