Billing Compliance Audits

Periodic billing compliance audits can help your organization avoid potential violations of federal, state and internal corporate compliance guidelines, as well as highlight operational practices that may cause duplication of work or poor cash flow. Warning signs that may prompt your organization to consider an external billing compliance audit include:

• Increasing number of Medicare claims selected for medical review
• High occurrence of denied claims
• Business office or billing staff turnover
• High occurrence of payment adjustments
• Poor cash flow

BKD Health Care Group can perform a billing compliance audit under client-attorney privilege if there is suspicion of compliance violations or as part of your organization’s corporate compliance plan. In addition, we can act as an independent review organization for providers subject to corporate integrity agreements. Our services include:

• Conduct interviews with billing staff
• Test billing transactions for consistency with medical documentation and payment accuracy
• Review billing reports to identify payment posting accuracy
• Report findings and recommendations to legal counsel

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