Billing Integrity Audits

It’s not uncommon to have concerns about whether your practice is billing and coding correctly, and in compliance. Because government and commercial payers mine claims data looking for improper payments—or even fraud and abuse—providers can gain peace of mind from a billing integrity audit.

 

How It Works

THG Consulting meets with you to discuss any specific areas of concerns. We develop an audit work plan. We select charts, based on your areas of concern. We may audit certain payers, or providers... or we may just take a random sample. Our certified coding experts review records, comparing clinical documentation to what was billed. We then present our findings, flagging areas of concern. We provide a clear action plan, and can provide coding education as needed.