Stop Leaving Revenue on the Table. Start With a Professional Medical Billing Audit.
Most healthcare practices lose 5% to 15% of annual revenue to preventable billing errors, denied claims, underpayments, and coding mistakes — without ever knowing it.
A professional medical billing audit from 247 Medical Billing gives you a complete, accurate picture of your revenue cycle health. We identify every dollar your practice is losing, show you exactly why it is happening, and provide clear steps to recover it.
- HIPAA Certified Audit Specialists
- 5+ Years of Revenue Cycle Expertise
- 98.6% Client Satisfaction Rating
- Audits for All Practice Sizes and Specialties
- Actionable Reports — Not Just Data Dumps
What Is a Medical Billing Audit?
A medical billing audit is a detailed, systematic review of your practice’s billing records, claim submissions, coding accuracy, payer contracts, and revenue cycle workflows.
The purpose of a billing audit is to:
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Find billing errors that are costing your practice money
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Identify compliance gaps that create legal and financial risk
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Detect underpayments from insurance companies
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Uncover denied claims that can be appealed and recovered
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Improve billing workflows to prevent future revenue loss
A billing audit examines your entire revenue cycle — from the moment a patient visit is documented to the moment a claim is paid and posted. Every step in between is reviewed for accuracy, compliance, and efficiency.
Why Does This Matter?
According to industry research from the Medical Group Management Association (MGMA):
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The average medical practice has a claim denial rate of 5% to 10%
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Up to 80% of medical claims contain some form of error
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Healthcare providers collectively lose an estimated $125 billion per year to billing errors and lost claims
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Only 35% of denied claims are ever resubmitted for appeal
These numbers mean that without a regular billing audit, your practice is almost certainly losing revenue that it has already earned and is entitled to collect.
A medical billing audit is not just a financial exercise. It is a critical tool for practice sustainability.
Why Medical Billing Audits Are Essential for Your Practice
Many healthcare providers focus on patient care and assume their billing is running smoothly. The reality is that billing errors accumulate quietly. By the time a problem becomes obvious, months or years of revenue have already been lost.
Here is what happens inside most practices that do not conduct regular billing audits:
Revenue Leakage
Revenue leakage occurs when money your practice earned simply fails to reach your bank account. Common causes include: Undercoding — Billing for a lower level of service than what was actually provided Missed charges — Services performed but never entered into the billing system Fee schedule gaps — Billing rates that have not been updated to reflect current payer contracts
Denied Claims Piling Up
Insurance payers deny claims for dozens of reasons. Without a structured process to analyze, appeal, and prevent denials, these dollars are simply left uncollected. Common denial causes include missing prior authorizations, coding errors, eligibility issues, and timely filing violations.
Coding Errors
CPT codes, ICD-10 codes, HCPCS codes, and modifiers must all be used correctly and in the right combination. Errors in any of these areas result in underpayment, denials, or — in worst-case scenarios — compliance violations and audits from payers and government agencies.
Compliance Risks
The Office of Inspector General (OIG) actively monitors healthcare billing patterns for potential fraud and abuse. Common compliance risks include upcoding, unbundling, billing for services not rendered, and improper modifier use. A billing compliance audit helps your practice stay protected.
Underpayments From Payers
Insurance companies sometimes pay less than what your contract entitles you to receive. Without a contract analysis and payment verification process, these underpayments go undetected and unchallenged.
Missed Reimbursement Opportunities
Practices that do not audit their billing often miss reimbursable services, add-on codes, and modifier opportunities that are entirely legitimate and properly documented — but simply never billed.
Signs Your Practice Needs a Medical Billing Audit Right Now
If any of the following situations apply to your practice, a professional billing audit should be your next step:
Revenue & Financial Indicators:
✅ Your practice revenue has declined without a clear explanation
✅ Your accounts receivable (AR) days are increasing month over month
✅ You are writing off more claims than usual
✅ Net collection rate is below industry benchmarks (typically below 95%)
✅ You are collecting less per visit than you were 12 to 24 months ago
Our Medical Billing Audit Services
247 Medical Billing provides a complete suite of medical billing audit services. Unlike competitors who offer surface-level reviews, we perform deep-dive analysis across every component of your revenue cycle.
How Our Medical Billing Services Process Works
Our Medical Billing Audit Process
We follow a structured, proven, six-step audit process that delivers clear findings and actionable results — without disrupting your practice operations.
Why 247 Medical Billing
Benefits of Working With 247 Medical Billing
What makes 247 Medical Billing the right choice for your medical billing audit?
Testimonials
What Our Clients Say
Help & FAQ
Frequently Asked Questions About Medical Billing Audits
A medical billing audit is a systematic, detailed review of a healthcare provider's claims, coding, billing processes, payer contracts, and revenue cycle performance. The goal is to identify errors, revenue losses, compliance risks, and improvement opportunities — and to provide a clear plan to address each finding.
Audit costs vary based on the size of your practice, the volume of claims reviewed, and the scope of the audit. We offer flexible pricing designed for solo physicians, group practices, multi-specialty clinics, and hospitals. Contact us at (888) 860-0859 for a customized quote. Initial consultations are always free.
Standard audits for small to mid-size practices are typically completed in two to four weeks. Larger practices, multi-location groups, or practices requiring in-depth compliance reviews may require four to eight weeks. We always provide an estimated timeline before beginning.
Our audits include: claims submission review, CPT/ICD-10/HCPCS coding accuracy analysis, modifier review, denial analysis, underpayment detection, insurance contract review, compliance assessment, workflow analysis, KPI benchmarking, and a comprehensive findings report with recommendations.
We recommend at least once per year for most practices. High-volume practices, those with elevated denial rates, or those that have recently changed billing systems or added providers should consider audits every quarter. Regular audits catch problems early before they compound.
Yes. Denial analysis is one of the most impactful components of our audit. We identify the specific reasons your claims are being denied, find appeal opportunities, and provide concrete steps to reduce your denial rate going forward.
Absolutely. 247 Medical Billing is HIPAA certified. All audit activities strictly follow HIPAA Privacy and Security Rule requirements. Patient data is handled with the highest level of security and confidentiality.
A coding audit focuses specifically on the accuracy of medical codes — CPT, ICD-10, HCPCS, and modifiers. A billing audit is broader and includes coding accuracy plus claims processes, payer payment analysis, denial management, compliance, contract review, and overall revenue cycle health. We include both in our comprehensive audit.
Common findings include: undercoding or upcoding, incorrect modifier usage, unbundling of services, missing documentation support, demographic and eligibility errors, timely filing violations, duplicate submissions, improper use of diagnosis codes, missed charges, and underpayments from payers.
Yes. Our audits identify previously denied claims that are still within the appeal window, underpayments that can be disputed, and billing errors that can be corrected and resubmitted. Many clients recover significant revenue within 30 to 90 days of completing an audit.
Revenue leakage is money your practice earned but failed to collect. It happens through missed charges, undercoding, unchallenged denials, underpayments, and write-offs that should not have been taken. Our audit systematically finds every source of leakage and quantifies the dollar impact.
Yes. We have experience with all major billing and EHR platforms, including Kareo, AdvancedMD, eClinicalWorks, athenahealth, DrChrono, NextGen, Practice Fusion, Medisoft, Greenway Health, Allscripts, and many others. We can audit your billing regardless of which system you use.
You receive a comprehensive findings report including an executive summary, revenue impact analysis, specific claim-level findings, compliance risk summary, KPI scorecard, and a prioritized action plan. We then provide implementation support to help you act on every finding.
Yes. In addition to one-time audits, we offer ongoing monitoring and periodic audit services for practices that want to maintain continuous revenue cycle performance. Ask about our ongoing audit and revenue cycle management packages.
Getting started is simple. Call us at (888) 860-0859 or submit our online form. One of our billing audit specialists will schedule a consultation, learn about your practice, and outline exactly what our audit will cover.
The billing audit from 247 Medical Billing identified over $40,000 in underpayments and denied claims we had no idea we were missing. The process was smooth, the report was clear, and they walked us through every finding.
Physician Group Practice Manager, Multi-Specialty Clinic