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- Phone:(406) 201-1528
- Email:info@billzprovidersolutions.com
- 1001 S Main Street Ste 500 Kalispell, MT 59901, United States
Subscribe to out newsletter today to receive latest news administrate cost effective for tactical data.
Monday - Tuesday:9am - 6pm
Friday - Sunday:8am - 5pm
Sunday: Closed
This involves reviewing claims, coding accuracy, documentation, and adherence to payer-specific guidelines to ensure that services are billed correctly and meet regulatory standards. Audits can be conducted internally by the healthcare provider’s billing team or externally by third-party professionals with expertise in healthcare compliance.
In addition to protecting against financial and legal repercussions, regular audits enhance operational efficiency and accuracy within the billing department. Through these audits, healthcare providers can refine their documentation practices, train staff on proper coding standards, and ensure consistent compliance with payer regulations and industry standards like ICD-10 and CPT coding guidelines.
Our expert team conducts comprehensive medical audits to help healthcare organizations ensure accuracy, compliance, and efficiency in their billing and coding practices. Our audits delve into every aspect of your billing process—from verifying coding accuracy and documentation to assessing claims for compliance with regulatory standards such as ICD-10, CPT, and HIPAA
Our team of seasoned professionals brings a deep understanding of current regulatory standards, including ICD-10, CPT, HIPAA, and payer-specific guidelines, allowing us to identify discrepancies and areas for improvement in your billing process. We don’t just identify issues—we provide actionable
By choosing us, you gain a partner committed to accuracy, transparency, and the success of your healthcare practice, allowing you to focus on what matters most: providing quality patient care with confidence in your financial processes.
we provide actionable recommendations to optimize your coding practices, documentation, and claims submissions, helping you reduce denials, improve cash flow, and stay aligned with industry standards.
HIPAA, the Health Insurance Portability and Accountability Act, is a U.S. law enacted in 1996 that sets standards for protecting sensitive patient health information (PHI). HIPAA was designed to improve healthcare access, streamline administrative processes, and ensure that individuals' medical information remains private and secure.
Privacy Rule: Governs how healthcare providers, insurance companies, and their business associates can use and disclose PHI, giving patients rights over their health information, including the right to access and control it.
Security Rule: Requires organizations to implement administrative, physical, and technical safeguards to protect electronic PHI (ePHI) against unauthorized access, breaches, or cyber threats.
Breach Notification Rule: Mandates that healthcare organizations notify affected individuals, the Department of Health and Human Services (HHS), and in some cases, the media, when a data breach involving PHI occurs.
By adhering to the rules and regulation critical for healthcare providers, insurers, and related organizations, as violations can result in severe financial penalties and damage to reputation.