Healthcare Audit | Revenue Cycle Coding Strategies

Healthcare Audits

It is vital that your organization operates at an optimized level to take full advantage of your efforts. It can be challenging to balance various projects and analyze performance to locate areas that could improve your organization’s operations. Most of the time, staff are unaware of the errors they are making, causing them to repeat the mistakes and costing the organization. If you believe that there are processes or areas that could potentially be improved or if you are not 100% sure that your organization is operating at its optimal level, then we recommend acquiring our medical audit services. As the recognized industry leader in specialty coding, documentation, and reimbursement, RCCS is ready to identify opportunities for improvement, highlight the root cause of your operational and compliance concerns, or provide insight to make confident decisions for the growth of your organization.

Our Healthcare Auditing Services

Billing, Coding, & Documentation Review

With experience in hospitals, freestanding clinics, and single-physician practice settings, the experts at RCCS are a trusted source you can turn to for billing, coding, and documentation reviews.

Our team will review your current medical billing and coding documentation to ensure charges are being captured accurately and follow payer or internal guidelines. Our team will begin the 3-step process.

  • First, we will review medical records, looking at the codes assigned compared to the associated documentation.
  • Next, we will conduct a root cause analysis to identify where the errors are occurring
  • Last, our team will present their insights and provide education recommendations based on best practices and authoritative guidance.

We believe that by reviewing past patient encounters, we will have a better understanding of your organization and the actions that have shaped it. By reviewing your medical records, our seasoned medical consultants can locate coding and documentation errors that are causing denials. Becoming aware of these mistakes can potentially increase your revenue and decrease the length of reimbursement periods. Operational audits can provide you with the insights needed to avoid and correct errors for future encounters and in some cases immediately.

Healthcare Compliance Audits

Privacy and security rules were developed by the government to enforce safe healthcare information management practices. Advances in technology have changed the precedent for security practices and specific coding compliance regulations have been developed to ensure patient information stays secure.

Coding compliance ensures that the coding of diagnoses, procedures, and data complies with all coding laws and guidelines. Compliance in healthcare is important and must be followed by all healthcare providers to keep confidential information safe. During the compliance audit, our team will analyze your current efforts and evaluate your coding compliance programs to provide you with detailed reports breaking down all crucial information. The reports will guide you with actionable information to maximize security and minimize risk for future encounters. The audit will also screen your compliance program and security technology to help you optimize billing systems. Medical coders support your facility’s quality compliance allowing for a healthier revenue cycle and reducing claim disputes and denials. Find out how compliant your current programs are or if there are any areas that could be improved.

Revenue Cycle Audit

How does your facility’s reimbursement rate compare with the industry’s benchmarks? What about your other KPIs?

If you believe that your facility is performing below average but do not know why, RCCS can help you! Our revenue cycle audit will analyze the front and back-end processes and uncover areas for improvement. The results will provide us with the pain points that are delaying or preventing timely reimbursement and help us identify the path to correct them. You will see a clear picture of your whole revenue cycle, understand where your organization stands compared to industry benchmarks, and find opportunities to grow with fee schedules/charge description master analysis.

The payer reimbursement audit will examine payor contract rates, Medicare rates and client fee schedules to ensure appropriate reimbursement. You will be able to visualize where your facility stands with the industry’s benchmarks. The audit will provide you with a visual process mapping from registration through zero patient balance. You will be able to visualize the patient’s financial experience for each service line and find key areas for improvement. RCCS offers a unique service because you will be able to understand the root cause of an area then proceed to the facilitation and implementation of best practice solutions.

Post-Audit Education and Training

Your staff is the most important part of improving processes. They play a role in every area of your organization and the services they provide. Investing in the proper training can improve current processes and benefit your facility overall.

If you decide to sign on to our audit services, RCCS can provide customized training for your team in any of the areas listed on this page. Our team will educate your staff with comprehensive information, clear steps, and recommendations based on authoritative guidance. Your team will learn to avoid mistakes and how to follow guidelines and regulations. Helping your team be efficient and making patient satisfaction their top priority.

Why are we one of the best healthcare auditing companies?

RCCS is the premier provider of healthcare compliance services in the industry. Our team has decades of experience in both clinical and non-clinical spaces and a multitude of specialties. We provide more than just audits and documentation reviews. RCCS also has teams dedicated to coding workforce support, charge capture analysis, staff training, and education, extensive healthcare consulting services, and more!
Not sure if you need training or consulting services? Let’s start with billing, coding, and documentation review or revenue cycle audit to provide you with the insights needed to locate areas for improvement. Then, we can consult you on actionable solutions and the training needed to ensure you do not make ongoing costly mistakes. We’ll leverage our 20+ years of experience in healthcare to assist providers in the industry with any healthcare needs. Our approach is to invest in training for your team, helping providers remain compliant while maintaining patient satisfaction as a top priority.

Success Stories

John is a facility owner who contracted RCCS Audit services. The audit found errors in the medical coding that John’s team kept repeating and were not aware of it happening. For John, Rccs was able to provide an overview of repeated errors and training needed to help the team avoid repeating the same mistakes. This quick fix was able to help John’s facility increase Revenue by 10% and decrease denial rates by 15%. “I did not know there were any errors in our current services, thanks to rccs my facility has all the resources to avoid revenue leaks. Highly recommend.”

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