Do you manage a healthcare facility?

Then, there must be an unending line of responsibilities and tasks. 

From managing administration to patient care, responsibilities never end. 

In the mixture of all these hardcore tasks, there lies a task that is both highly important and highly stressful for healthcare managers. 

Yes, I am talking about medical billing.

Medical billing serves as the basis of any healthcare facility such as clinics or hospitals but it is that much more difficult as well. Because a single mistake in medical billing can ruin the whole process and you may receive your rightful compensation. 

In 2021, there were 48.3 million denied claims. Claim denial or rejection is the worst nightmare of any healthcare institution. This is because all the financial setup of a healthcare system runs on this compensation. 

But we have a solution to these financial losses. A healthcare audit service is the best solution to all the problems. These companies will help you identify what is wrong with your system and they will also solve the problem. A medical audit company is a perfect companion for your healthcare setup.

If you are also stressed about continuous claim rejections and denials, worry no more. This blog will provide you with the best-ever healthcare audit service in the USA; Diligent Systems. Diligent Systems Worldwide is one of the best medical audit companies in the USA. With a great track record of clients, we stand out as the best affordable audit service in the USA. 

Understanding Healthcare Audits Services

First of all, let’s see what is healthcare audit services and why we need them.

In order to guarantee accuracy, compliance, and efficiency, healthcare audit services entail a thorough examination of medical billing, coding, and documentation procedures. 

Medical auditing assists healthcare providers in improving their revenue cycle, detecting fraud, and avoiding expensive billing errors. Auditors find discrepancies and suggest fixes by looking through patient records, insurance claims, and billing information.

Internal or external medical auditing may concentrate on particular topics such as Medicare compliance, correct coding, or problems with reimbursement. Maintaining high standards, adhering to industry regulations, and guaranteeing prompt insurance company payments all depend on routine healthcare audits.

Medical facilities can reduce risks and stay current with evolving healthcare regulations by collaborating with knowledgeable audit service providers like Dilijent Systems. Providers can improve financial performance while implementing the appropriate audit strategy.

Why Are Healthcare Audits Crucial?

Healthcare audits are highly important for any healthcare center. Here’s why medical auditing is important.

Ensure Accurate Billing:

Healthcare audits ensure accurate billing. Medical billing should be flawless and without any mistakes. Any mistake can lead to claim rejection or denial. That’s why medical billing audit companies focus a lot on accurate medical billing. Accurate medical billing serves as the basis of the correct RCM cycle. 

Compliance With Regulation:

Medical auditing companies ensure that all medical billing is aligned with the latest HIPAA rules. HIPAA rules are a set of USA federal law that describes rules and regulations regarding medical billing and coding. Complying with these HIPAA rules is highly essential.

If you fail to comply with HIPAA rules, you might have to face severe legal challenges. That’s why medical billing audit companies make sure that all the RCM steps are under the HIPAA rules.

Optimize Revenue Cycle:

Medical billing companies help a lot in optimizing the revenue cycle. By identifying inefficiencies, audits can streamline processes, leading to faster reimbursements and improved cash flow.

Enhance Patient Trust:

By providing a seamless cash flow system and reliable connections with the patient’s insurance company, you make a strong connection with the patient. Having a good connection with your customer i.e. patient is highly important in the medical field. 

Why Dilijent Systems, Worldwide?

There are a lot of medical billing and audit companies in the USA, so why should you go for Dilijent Systems?

Dilijent Systems is not just any ordinary company, with over 20 years of experience in RCM management, Dilijent Systems stands out as one of the best medical billing and audit companies with a client satisfaction rate of 99%.

We have customized and tailored services for every client. We understand that every business is different and that’s why we offer customized medical billing and audit services. 

Our key services include:

• Medical coding audit

• Medical billing audit

• Government and payer audits

• Clinical audits

• Collecting agent audits

• Medicare patient chart audits

Comprehensive Healthcare Audit Services

Here’s a detail about our healthcare audit services. Read the details so you can easily understand the type of service your business needs. Here’s a slight overview:Medical Coding Audit

We all know medical coding is the backbone of any healthcare practice in the USA. One small mistake and you may ruin it all. That’s why we are here to offer you medical coding audit services to help you in your coding practice. 

We will do a complete audit of your coding process making sure nothing is wrong. 

Medical Billing Audit

Medical billing is another great and important aspect of healthcare businesses. Medical coding depends on medical billing. If your company lacks medical billing, then you might not be able to achieve a nice revenue cycle. That’s why our professionals and experts will audit your billing process and see what’s going wrong.

Government and Payor Audits

Healthcare service providers also get orders from governmental bodies to perform audits. Dilijent Systems can help you handle all these audits. The audits can be from:

• RAC (Recovery Audit Contractor)

• OIG (Office of Inspector General)

• TPE (Targeted Probe and Educate)

• DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies)

Clinical Audits

Clinical audits examine the real treatment that patients receive. To determine whether patients are receiving the right care in accordance with modern healthcare standards, Dilijent Systems examines medical records. They verify that the treatment is safe, efficient, and compliant with regulations.

For instance, if a clinic is required to take a patient's blood pressure at each visit, the audit will confirm that this was done and recorded. These audits ensure that every patient is treated with the best practices in mind and contribute to an overall improvement in the quality of care.

Collection Aging Audit

Some medical claims submitted to insurance companies are eventually not paid. We call these "aged claims." To review all of these outdated claims, Dilijent Systems offers a Collection Aging Audit.

They determine whether the payments have not yet been received because of claim denials, coding errors, or missing information. Dilijent assists in resolving the issues so that the hospital or clinic can get the money they are due. 

By lowering outstanding balances and increasing cash flow, this procedure makes the facility function more efficiently.

Medicare Patient Chart Audit

Medicare has stringent guidelines for patient documentation and billing. To ensure that all Medicare patient records are accurate and comprehensive, Dilijent Systems conducts Medicare Patient Chart Audits.

To ensure that the services billed were truly rendered and accurately documented, they go over the complete chart, including the doctor's notes, test results, and treatments. 

This is crucial because Medicare may reject the claim or require repayment if there is inaccurate or missing information. Dilijent makes sure that providers maintain compliance and receive just compensation by auditing these charts.

Benefits of Partnering with Dilijent Systems

There are a lot of medical billing auditing services in the USA but why should you go to Dilijent Systems? 

Well, here are some benefits of partnering with Dilijent Systems that will make you select Dilijent Systems as your ultimate medical billing and auditing partner.

Expertise: With decades of experience in medical billing and coding, Dilijent Systems brings the best skills and talents to boost your business. We are experts in medical billing and coding. Get a free medical audit of your business by industry experts now!

Customized Solutions: every business is different and so every business needs different solutions. This is why Dilijent Systems brings tailored and customized solutions to every client. If you have any special requests or orders, feel free to ask.

Compliance Assurance: It is important to ensure that your partnering company follows HIPAA rules and regulations. In our case, you don’t need to worry about it. We are updated about all the compliances including HIPAA so your business doesn’t have to face any problems. 

Improved Revenue Cycle: After our medical audit, you will see a significant improvement in your revenue cycle. The revenue cycle depends on medical billing and coding so it is important to regulate them. Our audit will track the wrong things so that you can have a nice revenue cycle.

Data Security: As a HIPAA-compliant company, Diligent System takes care of your data and security.

Conclusion

Having regular medical billing audits helps you keep things together. Get the best healthcare audit services in the USA. Diligent Systems is here to make your life easy by providing excellent medical audit services. 

What type of audit is the most common in healthcare?

Random audits are considered the most common in healthcare audits. These types of audits can be performed at any time without focusing on a specific thing.

What is the difference between a medical audit and a clinical audit?

Clinical audit has multiple sections related to patients, education and training, health care delivery, resources for health, working relationships, and so on.

Who performs healthcare audits?

Audits may be performed internally or externally. Internal audits are done by internal management while external audits are performed by some other audit company.