The Audit Process

• Comparison of bank deposit totals with medical software totals
• Insurance payables analysis
• Patient payables analysis
• Payment postings analysis
  • Check for timeliness of posting
  • Ensure posting is done correctly as line-item entries
• Patient statements analysis
  • Ensure statements are sent on a timely basis
  • Proper format
• Collections analysis
  • How often accounts are sent
  • Why accounts are sent
• Claims in Medical Review
  • % of outstanding balance
  • why in Review? Improper information or coding?
  • Follow-up procedures in place?
• Aging analysis
  • 30/60/90/120
  • Look for unexplained write-offs, adjustments
  • A/R - Analysis of practice
• Coding analysis
• In-Network/Out-of-Network payments analysis

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