Catch Billing Errors Before Payers Do
What an Audit Reveals About Your Revenue Cycle

You submit claims every day in Covington without knowing whether your coding is accurate, your documentation supports the billed services, or your billing practices align with payer requirements and federal regulations. When a payer audits your practice or a government program reviews your claims, errors that seemed minor turn into overpayment demands, contract terminations, or fraud allegations that threaten your ability to operate.

EBilling Medical, LLC conducts compliance and revenue cycle audits by reviewing your coding accuracy, checking documentation against billed services, and identifying risk areas that do not meet healthcare regulations. We perform internal audits on a sample of claims, compare your billing practices to current coding guidelines, and prepare corrective action plans when we find errors or patterns that could trigger payer scrutiny. You receive written reports that describe each finding, explain the compliance risk, and recommend documentation improvements or workflow changes that reduce your exposure.

If your practice in Covington has not reviewed its billing and coding practices recently, contact EBilling Medical, LLC to schedule a compliance audit.

What an Audit Reveals About Your Revenue Cycle

We pull a random sample of claims from your practice management system, review the associated encounter notes, and compare the documented services to the CPT and ICD-10 codes billed to payers. During the review, we check for upcoding, unbundling, missing modifiers, and documentation gaps that would fail a payer audit. Practices in Covington that complete an internal audit before a payer requests records can correct errors and avoid repayment demands.

After we finish the audit, you receive a report that lists each claim reviewed, the errors found, and the potential financial impact if those errors appear across your entire claim volume. We also include a corrective action plan that outlines staff training topics, documentation templates, and workflow changes that prevent the same errors from recurring.

We conduct audits quarterly or annually depending on your risk profile, and we track repeat findings to confirm that corrective actions are working. This service does not include legal defense, representation during payer audits, or appeals of overpayment determinations.

Questions Practices Ask Before Scheduling an Audit

Medical practices considering a compliance audit usually want to know what the process involves, how long it takes, and what happens if the audit uncovers significant errors.

How many claims do you review during a typical audit?
We review a statistically valid sample based on your monthly claim volume, typically between thirty and fifty encounters. The sample includes a mix of evaluation and management visits, procedures, and high-dollar claims to cover the areas that carry the most compliance risk.
What happens if you find coding errors in our claims?
We document each error, calculate the potential overpayment or underpayment, and include it in your audit report with an explanation of why the code or documentation did not meet guidelines. You decide whether to self-report overpayments or implement corrective actions and monitor future claims.
How long does a compliance audit take from start to finish?
Most audits are completed within two to three weeks after we receive access to your claims and documentation. We spend the first week pulling records and coding, the second week analyzing findings, and the final days preparing your written report and corrective action plan.
What regulations do you review during a billing audit?
We check compliance with Medicare billing rules, Medicaid state-specific requirements, HIPAA privacy standards, and payer-specific policies that govern coding, documentation, and claim submission. We also review your compliance with the False Claims Act and anti-kickback regulations.
What happens if a payer audits us after you complete an internal review?
Your internal audit report helps you prepare for the payer audit because it identifies the same types of errors that payers look for during their reviews. You can use the corrective action plan to show the payer that you have already addressed the issues and implemented safeguards to prevent recurrence.

Practices in Covington that work with EBilling Medical, LLC for compliance auditing reduce their risk of overpayment demands and claim denials caused by coding errors or insufficient documentation. Reach out today to schedule your first audit and review your current billing practices.