A billing and coding audit that shows you what to fix first
A billing and coding audit gives you an outside look at a sample of your claims, coding, and denials, with clear findings ranked by impact. It's useful on its own, or as a first step before choosing a billing partner.
- Findings ranked by impact
- Coding and claims review
- Walkthrough call
The problems we hear about most
Before practices come to us for a billing and coding audit, these are the issues that keep coming up.
You can't see the leaks
Revenue problems hide in small patterns, like one modifier or one payer, that are easy to miss day to day.
Compliance worries
Over-coding and under-coding both carry risk. It's hard to know where you stand without an outside review.
Too many possible fixes
Even when you know something's wrong, it's hard to know which fix will make the biggest difference.
Everything included in our Billing & Coding Audit service
Certified billing and coding professionals handle every part of it, with HIPAA-compliant processes throughout.
Chart and coding review
A sample of encounters reviewed against documentation and coding guidelines.
Denial pattern review
Denials analyzed by reason and payer to find what's driving them.
Missed charge check
Services performed but not billed, or billed incompletely, are identified.
Compliance flags
Coding patterns that could draw payer questions are noted.
Ranked findings report
A clear report with fixes ordered by likely impact.
Walkthrough call
We go through the findings with you and answer questions.
How a billing and coding audit works with Optima
First, we set up a clear process from day one. That way, your claims keep moving while we get started.
Share a sample
You securely share a sample of claims, remittances, and documentation.
We review
Our certified coders and billers review coding, claims, and denials.
Get the report
You receive findings ranked by impact, with specific recommendations.
Talk it through
We walk through the report together and discuss next steps.
Is a billing and coding audit right for your practice?
Tap anything that sounds like your practice today.
Let's see if we're a fit
Select the statements that describe your practice to see whether Billing & Coding Audit would help.
What a billing and coding audit changes for your practice
A clear baseline
Know where your billing and coding stand today.
Prioritized fixes
Spend effort on the changes likely to matter most.
More confidence
Less uncertainty about coding accuracy and compliance risk.
A billing and coding audit for 30+ specialties
Our team works by specialty, so they know the codes, modifiers, and payer rules that apply to yours.
Services that work well together
Our free billing audit reviews a sample of your claims, denials, and A/R at no cost and with no obligation. A deeper coding and compliance audit can be scoped separately if you need one.
Usually a sample of claims, remittances, and the related documentation, shared through a secure channel. We'll send a simple list of what to pull.
No. The audit runs alongside your normal billing. Your team only needs to share the requested information.
No. The findings are yours to use however you like, with your in-house team, your current vendor, or with us.
See what a billing and coding audit could change. Start with a free audit.
First, we'll review a sample of your claims, denials, and A/R. Then we'll show you where your revenue cycle needs attention.