Boost Compliance with Medical Billing & Coding Audits from Former FBI/OIG Agents
Not only could your practice lose money because of poor medical billing, it could put itself at risk of extensive medical coding 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 keeps things organized while promoting accountability. It isn’t uncommon for a practice not to take advantage of this, which is why many have come to trust the team here at Fortis Medical Billing Professionals.
Put our highly experienced team on your side
Former Special Agent (OIG)
Former Special Agent
(FBI & IRS-CI)
Former Assistant Regional Inspector General
Former Supervisory Special Agent (DOD-OIG)
Director of Coding
Former Assistant Special Agent-in-Charge (HHS-OIG)
Former Special Agent-in-Charge (DEA)
Former Special Agent (FBI)
Our Auditors Can Improve Your Team’s Compliance and Revenue
This includes narrowing the margin for error and common downfalls such as:
A Lack of Organization within the Practice, for Both Patient Care and Patient Billing
Successful practices all have something in common: streamlined processes and an organized approach to 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 are 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. 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 have a first-class experience without headaches.
Becoming a Victim of Fraudulent Claims that Negatively Impact the Practice
With an experienced medical coding 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 types of fraudulent medical claims include:
Billing for Uncovered Services – Often there are healthcare services that insurance companies refuse to cover. When this happens, a patient may be eligible for the service in question; billing for this frequently could lead to billings being considered fraudulent.
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 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. 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 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 reduces the amount of reimbursement.
Upcoding – Simply put, this happens when a practitioner (or medical facility) bills for more than they provided. A couple of examples include rounding 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 in Best Medical 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 subject to constant changes and it can be quite difficult to stay on top of things.
By hiring an experienced medical coding audit 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. Often, many practitioners prefer 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.
Failing to Take Opportunities to Drive Revenue to the Practice
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 medical billing audit can help uncover these discrepancies and harness the revenue once and for all.
Not Having Billing Policies Aligned with Current Laws and Regulations
As 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 must have billing policies that adapt to these changes. 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 medical 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 with medical billing compliance, we ensure that every one of our clients is always compliant. You can think of it as the offensive team for your healthcare practice.
Many times, physicians and medical practices find themselves with outdated processes, and this could lead them down a road full of headaches and troubles. Instead of waiting for a federal billing audit or any other type of backlash, we pinpoint any weaknesses in the compliance programs of our clients and address them accordingly. A medical coding 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 medical 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 because of our custom-tailored approach to medical billing audits that is specific to the needs of their practice.
Some areas covered in our medical billing audits include, but are 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 billing or medical coding audit or you are fixing to undergo one, Fortis provides the most comprehensive and most efficient medical coding audits offered by any medical billing and coding company. You can rest assured that you are truly in the hands of the best.
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.
We Are Here for the Healthcare Organizations that Want to Stay Local while Outsourcing!
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 Medical Coding Under Control while Minimizing Potential Liabilities?
If you’re ready to get your billing audits done and take your practice to the next level, reach out to us today and we’ll ensure that you’re well taken care of. Contact us online or call us directly at (866) 808-4160.
We will start by learning how things are done within your practice and how they can be improved in a way that leads you to a better bottom line.
Tag: Medical Billing & Coding Audit Services