Billing Audits

Fortis Medical Billing Audits

Not only could your practice lose money due to poor medical billing, it could be putting itself at risk of extensive audits by the government.

Medical billing and coding should not be taken lightly. An improper code that is included in your billings, or non-compliance with the latest federal regulations, could lead you down a road that no practice wants to be taken down.

One thing that successful healthcare facilities and practices have in common is that they have implemented a system of processes that always keeps things organized while helping them remain accountable. It isn’t uncommon for a practice not to be doing this, which is why many have come to trust the team here at Fortis Medical Billing Professionals.

Our Professionals Have Set Out to Defeat All Medical Billing Issues

This includes uncovering room for error and common downfalls such as:

A Lack Of Organizing Within The Practice, For Both Patient Care As Well As Patient Billing

Successful practices all have one thing in common, streamlined processes and an organized approach when it comes to dealing with the business aspect of healthcare. Many have trusted the wrong companies while others are searching for the perfect solution.

Whatever the case may be, Fortis Medical Billing Professionals is dedicated to helping healthcare providers and facilities make the most of their success. Without having to worry about slowing their growth due to inefficient billing practices or potential liabilities.

On top of providing an adequate solution for the business side of things, we also work hard to enhance the patient experience as well. By providing accurate billings, proper filings, and a streamlined process when caring for patients, we allow practices to embrace a modern way of doing business while their patients embrace a first-class experience without headaches.

Becoming A Victim Of Fraudulent Claims That Negatively Impact The Practice Itself

By having an experienced billing audit company on your side, you can easily implement solutions that can detect fraudulent claims before they even have a chance to happen. This helps practices prevent any legal backlash that can come from fraudulent billings.

Some of the types of fraudulent medical claims include:

Billing for Uncovered Services – A lot of the time there are healthcare services that insurance companies refuse to cover. When this happens, a patient may be eligible for the service in question but billing for this frequently could lead to billings being considered as fraudulent billing practices.

Billing for Unnecessary Services – By signing off on a billing document, you’re agreeing that the services provided are accurate, medically necessary, and complete. Keep in mind that the services you can bill for are within your state plan, so the requirements do vary for each provider making it critical to implement ethical billing practices.

Billing for Services Not Provided – This is not uncommon in the medical field, and it is one of the biggest types of insurance fraud today. Practitioners have been known to bill for services that they did not provide to their patients. By having a strict accounting system in place that ensures accountability, you will be able to easily prove that the services that you have billed for were truly provided to the patient.

Unbundling – While it has been a temptation that has led facilities and providers to be subject to fraud investigation, it’s not the right way to go about things and it could put not only the provider but the facility at risk of implications. Unbundling is when provided services are billed individually to get paid more by the insurance companies since bundling them does reduce the amount of reimbursement.

Upcoding – Simply put, this happens when a practitioner (or medical facility) bills for more than what they provided their patient with. A couple of examples include billing up to half-hour increments to increase reimbursement or billing for more expensive medications when the generic version was used. While this is a more complex type of healthcare fraud, it is also one of the most common types we see today.

Having Improperly Trained Staff When It Comes To Best Billing Practices

While you might think that sending your employees to a medical coding class or seminar provides them with all the information that they need to understand and implement best billing practices, this isn’t the case. The medical industry is one that’s subject to constant changes and it can be quite difficult to stay on top of things.

By hiring an experienced medical billing and coding company, not only will you have someone on your side that understands this side of the business inside and out, but you’ll find that it’ll be easier to train your staff properly. A lot of the time, many practitioners prefer to have their staff trained by a company that’s experienced with preventing medical fraud and implementing best billing practices to minimize their liabilities as much as possible.

Letting Opportunities To Drive Revenue To The Practice Pass By Without Any Notice

More times than not, practices pass up the opportunity to drive revenue without even knowing that it’s slipping right past them in plain sight. This could be due to not resubmitting denied claims, not billing for services or supplies properly, or even miscoding their claims. A billing audit can help uncover these discrepancies and harness the revenue once and for all.

Not Having Billing Policies In Place That Are Aligned With Current Laws And Regulations

As was mentioned earlier, the government likes to change up laws more than anyone else and insurance companies love to change their billing regulations. Not to mention, billing codes get changed up regularly as well.

To ensure the future of your practice is secure, you have got to have billing policies in place that adapt to these changes as they happen. It can be tough to provide your patients with the best care and do this at the same time. That is why having a professional billing audit can not only pinpoint where you’re falling behind, but the direction things need to be shifted as well.

At Fortis, we ensure full compliance while driving revenue to your practice.

Being founded by a federal attorney with extensive experience when it comes to medical billing compliance, we ensure that every one of our clients is always compliant. You can think of it as the offense to your healthcare practice.

Many times, physicians and medical practices find themselves with outdated processes, and in turn, this could lead them down a road full of headaches and troubles. Instead of waiting for a federal audit or any other type of backlash, we pinpoint any weaknesses in the compliance programs of our clients and address them accordingly. A billing audit can be done at a clinical level, financial level, as well as policy-specific level dependent on the specific needs of the hospital or practice being served.

We provide high-quality billing audits to healthcare organizations of all sizes.

Whether you run a small clinic or large hospital, many organizations of all sizes and types have come to find that Fortis Medical Billing Company can provide them with the ultimate solution. This is due to our custom-tailored approach to billing audits that is specific to the specific needs of their practice.

Some of the areas covered in our billing audits include, but is not limited to:

  • Audits of Medicare Patient Charts
  • Exposing Weak Billing Practices
  • Finding the Core Reason for Denials
  • Identifying Missed Charges
  • Uncovering Potential Liability Issues

Whether you want to eliminate the risk of a federal audit or you are fixing to undergoing one, Fortis provides the most comprehensive and most efficient billing audits offered by any medical billing and coding company. You can rest assured that with us, you are truly in the hands of the best.

In the end, we benefit our clients in more than one area of their business.

Our goal is to benefit our clients in every aspect of their business. We understand that the healthcare industry can be quite complex, and we match that level of complexity with refined processes that have been proven to deliver our clients with a level of service other companies cannot. Our team of former federal investigators, experienced billing auditors, and lawyers specializing in compliance continues to provide us with this rather unique competitive edge.

For the healthcare organizations that want to stay local while outsourcing, we are here!

Based in the beautiful city of Dallas, we maintain a local focus to ensure that our clients get the highest level of service possible. While many medical auditing companies outsource to other companies, we love the fact that we can employ those within our communities while doing what we love.

Not to mention, this also makes the communication process painless as well. All too often we hear from clients who have used other companies only to be frustrated by the lack of understanding by their employees. We are here to change the world of medical billing, in a way that nobody else has ever done before. It just might be another ingredient that has contributed to our growth over the years.

Ready To Get Your Billing Audits Under Control While Minimizing Potential Liabilities?

If you’re ready to get your billing audits done and take your practice to the next level just as our clients have, reach out to us today and we’ll start doing whatever it takes to ensure that you’re well taken care of. Contact us online or call us directly at (866) 808-4160.

We will start by understanding how things are done within your practice and how they can be improved in a way that leads you to a new and improved impact on your bottom line.

Contact

Dr. Stephen Taylor

Dr. Stephen Taylor has 25 years as a medical billing specialist and consultant.

Beverly Gibson

Ms. Beverly Gibson has been a health care consultant for more than 25 years and specializes in medical record auditing, E/M training, and audit risk mitigation.