SRA/Exclusive Medical Billing Audit
Alpha1 Healthcare Solutions, our team of qualified and HIPAA-certified professionals performs exclusive audits upon request.
SRA/Exclusive Medical Billing Audit
Security Risk Analysis/Medical Billing Audit: At Alpha1 Healthcare Solutions, our team of qualified and HIPAA-certified professionals performs exclusive audits upon request. We thoroughly analyze the complete facility mechanism and medical billing operations of medical practices/institutions offering any medical specialty, without interrupting the existing workflow.
It all starts with a brief case study and analysis of all the ins and outs (modes, tools, mechanisms) based on the parameters of AMA, HIPAA, HHS, and CMS guidelines/protocols. We ensure that none of the processes breach security protocols for PHI (Protected Health Information) and PII (Personally Identifiable Information). We refine the complete process and administrative ideology of facilities to ensure development and healthy revenue while following the appropriate rules and guidelines.
In this detailed audit, we evaluate and expertly check your existing medical billing operations and modules to provide you with a clear picture and understanding of what exactly is happening with your billing and the required measures that need to be deployed if there are any loopholes or revenue leakage. We keep an attentive eye on over-coding, under-coding, as well as ignored AR (Accounts Receivables), denied, and rejected claims.
Alpha1 Healthcare Solutions is always determined to ensure the quality and appropriateness of every essential component that affects the healthcare process, patient care, and facility revenue.
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Major Components of Audit
- Verification of information exchange modes.
- A complete data verification report of all providers in the group.
- Current EDI/ EFT
- Enrollment/ Credentialing status.
- Claims’ breakdown on the basis of scheduling
- Pending Claims/ AR (Accounts Receivables)
- Denied Claims/ Rejection
- System usage analysis
Alpha1 HealthCare Solutions always follows compliance & guidelines. In order to undertake an audit, it requires having a signed BAA (Business Associate Agreement) between the HealthCare facility and Alpha1 HealthCare Solutions.
Alpha1 HealthCare Solutions takes 7 to 15 Business days, depending upon the size of the facility to present the complete detailed audit.