Find Revenue Leaks Fast with Our Medical Billing and Coding Audits
Gain Clarity and Compliance with Expert Billing Audits
Are coding mistakes, billing errors, or denied claims impacting your cash flow? Our billing and coding audit services uncover every issue so your practice can recover revenue, reduce rejections, and stay fully compliant with payer and Medicaid requirements.
- Accurate billing and coding audits made easy for any practice size
- Scalable audit models including risk-based and focused evaluations
- Faster reimbursements with 99% first-pass resolution
- HIPAA-compliant audit reports that meet payer and regulatory standards
Medical Billing and Coding Audits Built for Revenue Integrity
Coding errors, missed modifiers, and outdated payer rules can drain thousands from your bottom line. We deliver end-to-end medical billing and coding audit services that uncover every inaccuracy, benchmark your performance, and give your team a clear, step-by-step plan to recover revenue and stay compliant.
Risk-Based Billing and Coding Audit
We focus on high-risk CPT codes, frequent denials, and payer-specific red flags. This audit type helps you uncover issues that could lead to penalties or payer reviews. You get actionable insights to make corrections before problems grow.
Targeted Billing and Coding Audit
If you're facing problems in a specific area like anesthesia billing, modifier misuse, or recurring underpayments, this audit isolates the cause and gives you clear steps to fix it. It works best when you're already aware of specific revenue challenges.
Scheduled Compliance Audit
Our recurring audits, conducted quarterly, semi-annually, or annually, track your billing accuracy and ensure compliance with changing payer guidelines. These reviews help stabilize your revenue and maintain long-term financial health. We make medical billing and coding audits straightforward, focused, and results-driven. Each audit includes a clear report, prioritized recommendations, and dedicated support to help you improve accuracy and protect your bottom line.
How We Audit Your Billing and Coding for Maximum Accuracy
We don’t just scan claims. We investigate every layer of your billing process to catch what others miss. Our medical billing and coding audit services are built to identify coding errors, lost charges, and payer compliance risks that impact your bottom line. Here’s how we do it:
Understand Your Billing Rules
We begin by reviewing your internal billing policies, coding practices, and payer contracts. This gives us a clear picture of how your billing system operates and where errors are most likely to occur.
Analyze the Data
We dig into your EHR data, claims history, denials, and reimbursements. This step helps us identify billing and coding errors, claim patterns, and high-risk areas affecting performance.
Review Documentation
Our team inspects clinical documentation, CPT and ICD-10 code usage, modifier application, and medical necessity alignment. This hands-on coding audit helps us ensure accuracy and uncover hidden issues.
Share Clear Findings
You receive a detailed report showing what’s wrong, why it matters, and how to fix it. We provide a clear action plan that helps you correct billing errors, reduce future denials, and improve claim acceptance.
Guide Your Team Forward
We don’t leave you with a list. We provide follow-up support, optional coder training, and compliance check-ins so your team can implement changes confidently and avoid repeated mistakes.
Why Healthcare Providers Prefer Our Medical Billing and Coding Audit Services?
We combine deep audit expertise with real-time support to make your billing process faster, cleaner, and fully compliant. Our medical billing and coding audit services uncover hidden revenue gaps, reduce denial rates, and strengthen claim accuracy without interrupting your team’s workflow.
Each audit is a strategic opportunity to elevate performance, not merely a compliance task. From patient data handling to audit documentation, every step is secure, seamless, and fully HIPAA compliant. You gain clarity, accuracy, and faster payments without any back-and-forth delays.
Why Healthcare Facilities Choose Our Medical Billing Audit Services?
Rapid Revenue Recovery
First-Pass Resolution
Denial & Rejection
Short Turnaround Time
Electronic Claim
Electronic Payment
Client Retention
Revenue Increase
Specialties We Strengthen With Our Medical Billing and Coding Audits
We tailor every audit to the rules, payer edits, and documentation demands of your specialty. That focus allows us to spot code-level errors fast, improve first-pass claim accuracy, and protect your revenue against payer take-backs.
By combining specialty-specific knowledge with proven medical billing and coding audit services, we help providers cut denial rates, reduce audit risk, and unlock greater reimbursement.
Our Expertise
- - Patient Scheduling & Registration
- - Verification of Benefits
- - Authorization & Referral
- - Medical Billing
- - Medical Coding
- - Medical Billing Financial Audit
- - Charge Entry & Payment Posting
- - Billing & Coding Audit
- - Denial Management
- - AR Management
- - Revenue Cycle Optimization
- - Old AR Management
- - Patient Billing & Statements
- - Collections Services
- - Patient Help 24/7
Medical Billing Software We Leverage for Revenue Cycle Management
Here are some Industry top listed EHR being operated by us.
Our Esteemed Clients' Testimonials
![Dr.-Jorge-Guevara-MD[1]](https://prombs.com/wp-content/uploads/2024/10/Dr.-Jorge-Guevara-MD1.webp)
Pro Medical Billing Solutions is doing an incredible job of boosting our revenue and improving our cash flow. They are excellent at communicating with the insurance providers and are prompt in addressing issues. We're immensely grateful for their wonderful efforts, and we give a thumbs-up to their entire team.
For the past 15 months, Pro Medical Billing Solutions has consistently delivered incredible collection results, with first-pass rates surpassing industry standards. Their high responsiveness and effective Revenue Cycle Management services make them the go-to choose for any practice looking to take control of their billing.
![Dr.-Charles-Sisson[1]](https://prombs.com/wp-content/uploads/2024/10/Dr.-Charles-Sisson1.webp)
We rely on Pro MBS for our medical billing operations and analysis. Our collaboration with Pro MBS has allowed us to excel over the last five years. We had a few patients’ inflows initially, and we ended up getting many more clients, Pro MBS helped us scale.
![Jennifer-Hartley-Administrator[1]](https://prombs.com/wp-content/uploads/2024/10/Jennifer-Hartley-Administrator1.webp)
Thanks to Pro Medical Billing Solutions, our practice has seen a significant improvement in our billing and collection processes. Their team is always up-to-date with the latest industry changes, and they have provided excellent support to our staff. We would highly recommend their services to any healthcare provider.
We have been using Pro Medical Billing Solutions for several months, and we have been extremely satisfied with their services. They have helped us to optimize our billing and coding practices, resulting in improved cash flow for our practice. We highly recommend them to other healthcare providers.
![Huiping-Xu-M.D[1]](https://prombs.com/wp-content/uploads/2024/10/Huiping-Xu-M.D1.webp)
Pro MBS has provided excellent satisfaction for our Medical Billing and Coding operations. We conduct regular meetings with their team. They are updated with current industry trends and keep very high standards for quality service. We consider them as an extension of our business office.
![Sandra-Diaz[1]](https://prombs.com/wp-content/uploads/2024/10/Sandra-Diaz1.webp)
Pro Medical billing Solutions has numerous strengths. One of many is effective communication, which kept me aware of billing updates and claim processes. I am impressed with the swift claim processing and the turnaround time for claims. appreciate Pro Medical Billing Solutions for providing constant support.
![Jennifer-G.-Walker-D[1]](https://prombs.com/wp-content/uploads/2024/10/Jennifer-G.-Walker-D1.webp)
We are pleased with Pro Medical Billing Solutions' billing and coding services and highly endorse them to anyone looking for a proficient billing company. Collaborating with Pro Medical Billing Solutions has been effortless, and we are deeply grateful for their services.
As the CEO of Big Dog Pharma, I would highly recommend Pro Medical Billing Solutions for your Medical Billing and Coding processes. Over the past four years of collaboration, I have found them responsive, prompt, and helpful. Through our extension, we reduced our staff requirements and significantly improved our revenue stream.
![Dr.-Michael-Farrel-D[1]](https://prombs.com/wp-content/uploads/2024/10/Dr.-Michael-Farrel-D1.webp)
I look back over the past five years of our relationship, and I can predict what the coming five years would look like. I can see immense growth opportunities for both of our organizations with the partnership that we have been able to develop. I absolutely recommend Pro Medical Billing Solutions.
Frequently Asked Questions
A billing and coding audit is a detailed review of medical records, submitted claims, and coding accuracy. It helps identify billing and coding errors, ensures compliance with payer and Medicaid rules, and improves reimbursement rates.
These services uncover patterns in claim denials, analyze code usage, and verify documentation accuracy. By correcting billing and coding errors early, audits help providers reduce rejection rates and improve cash flow.
Anesthesia practices often face challenges with time units, modifiers, and concurrency documentation. A specialized anesthesia billing and coding audit ensures accurate coding, correct reimbursements, and fewer compliance risks.
Audits are typically recommended quarterly or semi-annually. Regular billing and coding audits help providers maintain compliance, reduce billing errors, and stay prepared for payer or Medicaid audits.
A focused audit targets a specific area of concern like underpayments or modifier misuse. A risk-based audit prioritizes high-risk CPT codes, payer types, or services that are most likely to trigger audits or revenue loss.
No. Proactive coding audits help prevent billing issues before they happen. Routine medical billing and coding audits protect your revenue and support cleaner claims long term.
Common findings include incorrect CPT or ICD-10 codes, improper modifier use, undocumented services, and missed charges. These billing and coding errors can lead to delayed payments or compliance penalties.
Yes. We use advanced audit tools to analyze large sets of claim data, identify trends, and benchmark performance against payer rules. This improves audit accuracy and turnaround time.
Yes. Our auditors are trained to meet Medicaid documentation standards. We help you prepare for Medicaid audits by ensuring coding accuracy, record completeness, and audit trail compliance.
We deliver specialty-focused audits, certified auditing professionals, HIPAA-secure processes, and follow-up support. Our audits are designed not just to find errors but to fix them and prevent future issues.
What Sets Our Medical Billing and Coding Services Apart
Experience
857 Tristar, Suite A1,
Webster,
TX 77598, US.
2300 W Sahara Avenue, Suite 800,Las Vegas, NV 89102, US.
1600 Broadway, Suite 1600, Denver, CO 80202, US.
732 S 6TH ST, STE R, LAS VEGAS NV 89101, US.
5600 General Washington Dr Ste B207, Alexandria, VA, 22312, US.
Thousands of providers growing their practice with PROMBS.
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