The Role of Medical Auditing in Ensuring Compliance and Protecting Your Medical Billing License

It is often said that failing to prepare is the same as preparing to fail. If you are a healthcare organization or professional that accepts Medicare patients, failing to prepare for an audit of your billing records can mean hefty fines and penalties for you or your practice.

Rather than wait until you are audited, spot and correct problems before they cost you money and your medical billing license. You can perform internal audits of your billing practice or have an outside private entity audit your records.

The What, Why, and How of Auditing Your Billing Practice

Auditing your medical billing practice involves systematically reviewing your practice’s billing procedures and records. An entire review of all of your records is often not necessary. Instead, reviewing a sample of sufficient records can suffice to give you a picture of any deficiencies or risks in your business.

An audit can either focus on payments and billing that have already taken place or look at claims that have yet to be submitted for payment. In either event, your audit should review the selected records to determine whether they comply with federal and state laws and regulations.

Finding records that you or your auditing team identify as not complying should motivate you to implement systems that can identify and reduce the incidence of such errors in the future. You might also adjust the way you allocate resources and attention to ensure you review the types of non-compliant records you found more carefully.

Why Medical Auditing Is Crucial to Keeping Your Medical Billing License

Errors in submitting claims can result in overpayments and other mistakes. Any single error can be costly, but repeated errors can lead to losing your medical billing license. Regular audits safeguard against these consequences, allowing you to catch and correct mistakes before state or federal auditors find them.

Hallmarks of Effective Auditing

An occasional audit here and there will not help you or your business much. Instead, audits should be a regular and routine part of your practice’s operations. The greater the volume and variety of claims and payments you process, the more frequently you may want to consider conducting audits.

You should audit how your practice submits various types of claims, carefully scrutinizing those records you have chosen to review to ensure they are coded correctly and are compliant with all relevant laws. When mistakes are found, you should not only identify those errors but also explain them to your staff along with the correct procedure.

When to Call a Medical Billing License Defense Lawyer

You do not need to wait until you are audited by state and federal authorities to seek help. An experienced medical billing license defense lawyer in California from S J Harris Law can help you conduct an audit of your practice today and avoid problems in the future.

If you are currently facing penalties for a failed audit, S J Harris Law can provide skilled advocacy and help you keep your license.

Whatever your need might be, trust S J Harris Law to be there to meet it. Contact us today.

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When dealing with these complex issues, you need legal representation that has a long track record of success in these types of cases. Scott Harris and the rest of our team at S J Harris Law will be ready to help you pursue any option available that allows you to keep your license and continue working, no matter what industry you are in.


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