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Compliance Audit Services

Compliance Audit Services are like a trusted guide for healthcare businesses. They help make sure these companies play by the rules of the government and the groups that pay for healthcare. Compliance audits are important because if a company doesn’t follow these rules, it could have to pay a lot of money, up to $1.5 million for each mistake (HHS says so).

Here are some big reasons to get help from these audit pros:

They save you money by catching billing mistakes that can cost 20–30% less if you fix them early.

They make sure you're following the strict rules of HIPAA, OIG, CMS, and other important letters that keep everyone's information safe and payment systems honest.

They find any holes in how you work now so you don't make the same mistakes again.

By using a team of experts, you can keep your business running smoothly and keep the money coming in without any surprises.

So, if you want to stay on the good side of the law and keep your finances healthy, think about getting professional compliance audit help.

Need for Compliance Audit Services

The rising number of rules makes compliance auditing software a necessity. It is crucial for companies in the healthcare field to handle checks called healthcare compliance audits in the right way. These audits are like guides that make sure you’re sticking to all the important rules so you don’t have problems with the groups that oversee your work.

Here’s why it’s so important:

Many clinics get checked every year (MGMA says 68%).

It stops money problems from little mistakes in paperwork and codes.

It makes sure you're following the big rules for getting paid by the government.

Using a good plan for checking helps you build a good name with the people who pay for healthcare and the people who get care from you.

So, using these tools can save you from trouble and make everyone happy.

Compliance Audit Process

Understanding the process of compliance audits is pivotal for those who work in healthcare. It helps keep things clear and correct and gives you ideas on what to do next.

Here’s how it typically goes:

First, they look at all your important aspects, like computer records and money papers.

Then, they check if you're playing by the rules and doing things right when you write down what happened and ask for payment.

They use some special tools to figure out if there might be any problems.

In the end, you get a big paper that tells you exactly what they found and what you should do to get even better.

Did you know? Places that do these kinds of audits often see their problems go down by a lot, like 35% in just one year! (That’s from a big group called AHIMA.) To ensure a smooth and streamlined compliance audit service process, join hands with Practolytics.

What we promise to do for your Revenue Cycle Management_

Why Choose Practolytics for Compliance Audit Services

What we promise to do for your Revenue Cycle Management_

Among the top compliance audit companies, Practolytics is special because it has great tools and smart people, and you can see that it works well. As an efficient compliance audit company, they make sure their help fits your business.

Why choose Practolytics?

They have a group of people who are experts at auditing because they know CMS, HIPAA, and how insurance companies check things.

They use computers that are efficient at finding mistakes in billing and coding.

You get reports that are made just for you, with easy-to-see information in real-time.

They have a history of making sure clients don't have to worry about audits as much, reducing risks by 40%.

When you work with Practolytics, you get more than just a list of things to do. You get a partner who makes sure you’re always ready for an audit. When you look for “best compliance audit companies”, ensure you know exactly what you are looking for. That’s why Practolytics is the easiest and best choice.

Benefits of Compliance Audit Services

Our experts work to improve your process efficiencies & rectify errors

Partnering with the best compliance audit services is a smart business move. It gives you big-time operational and financial pluses. Here’s why:

Spot compliance issues early: Regular checkups find problems before they grow big.

Get more money from claims: Better success with insurance claims means fewer fights.

Stay clear of government troubles: avoid pesky fines and penalties with good audits.

Look like a pro: Continuous audits make your clinic a trustworthy, well-run care place.

Foster a workplace of honesty and responsibility: Audits help everyone play by the rules.

So, teaming with the right people helps your business stay secure and successful in the healthcare industry.

Our experts work to improve your process efficiencies & rectify errors

Customer stories

Practolytics has been invaluable to our practice since October 2022. Their expertise in coding guidance and provider audits has given us more confidence in the way we operate. Their team is not only knowledgeable but also incredibly supportive providing clear and concise guidance tailored to our specific needs. Their compliance audits have been thorough and insightful, helping us to identify areas for improvement that could prevent financial losses while also providing opportunities for further provider training. I highly recommend their service to anyone looking to enhance their billing and coding practices.

Carol Raugust – Practice Manager Platinum Hospitalists

Customer Stories

I have been a very satisfied client with Practolytics for nearly 5 years now. As you would expect, they are collecting the money that we have worked so hard for. We like the fact that they share our passion for data. We both approach our common issue i.e., how to collect money from a data centric viewpoint, and this drives improvement. The team is always willing to listen to us and make changes if necessary. Through the years we have asked for help with various office activities from credentialing to prior authorizations to procurement of outside medical records. Yes, these were add on-services, but outsourcing these activities to their team has been a winning solution that has intertwined the billing team into the success of our practice. These add ons have been a good value for us too. Lastly, we have easy access to one of the principal partners on the billing team, and the response time has always been excellent. Thank you! Practolytics!

Guy Lerner – MD Specialist in Pain Care, Kentucky

Customer Stories

We have been working with Manik and the rest of his team since August 2015. At that time, we were a clinic in need of guidance, in terms of credentialing, understanding the claims process and optimizing the use of the technology and stabilizing cash-flow. The team as a whole spent many hours upfront working to get everything moving smoothly and also developing relationships with most insurance companies. Manik’s hard work & dedication paid off as our practice more than tripled in visits, and we no longer had to tell the patients that we aren’t in the network. This more than anything has allowed us great patient flow and continued steady growth.

Robert Gass – Owner Care Physical Therapy, New York

Customer stories

We are a solo orthopedic practice in North Carolina and our relationship with Practolytics started in June 2015. They have staff members who are always willing to help. They work very hard to make us happy and I appreciate all that they do on a daily basis. They take out the worry of getting payments and always follow up with insurance companies. I found the customer service to be unsurpassed. All phone calls are returned and our questions are answered in a thorough and timely manner. The monthly reports are easy to read and provide a quick assessment of the health of the practice, including the company’s account receivables. When I need advice or am unsure of something, it gives me comfort to know that they are just a phone call away. Switching to Practolytics was truly one of the best decisions that I have made for our practice. I truly look forward to a longtime relationship with the staff at Practolytics.

Rekha Parikh – Administrator Orthopedic Solutions & Sports Medicine Center, North Carolina

Customer Stories

I started a new practice approximately 5 years ago. I have used Practolytics for my billing services over this entire period. I have also used them for integration of collections, adding new providers and DME. They have been excellent and are also part of the reason why I am so successful. They are very knowledgeable about billing. I not only see patients in clinic but also at the hospital and nursing home and also do surgical procedures in and out of the office. I have been very impressed with their level of skill and knowledge. They also do very good on communication. I would highly recommend them for any of your billing needs.

Dr. Nicole Cupp – MD Advanced Podiatry of Bartlesville

Customer Stories

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Guy Lerner
Rekha Parikh

FAQs about Compliance Audits

How can I maintain compliance between audits?

To keep on top of things, use ongoing monitoring tools, train your team well, and consider helpful computer software that checks for compliance.

What documentation should I provide for a compliance audit?

You will have to check your computer records for patients, the history of bills you’ve sent out, the codes you utilize, and the rules you’ve established for playing fair.

How does a compliance audit protect me from liability?

These audits enable you to catch and correct issues before the big boys do, which can save you significant money and headaches.

Are compliance audits required by law?

While not always necessary, they are highly recommended and occasionally required by insurers or CMS.

What happens if my practice fails a compliance audit?

You will receive a corrective action plan. Failure audits don’t result in penalties except in cases of severe or uncorrected violations.

What is the difference between an internal and external compliance audit?

Your staff conducts internal audits. External audits use third-party specialists for an objective examination.

How long does a compliance audit take?

This entire procedure can take from one week to one month, depending on how large and complicated your healthcare business is.

Will the audit disrupt my clinic’s daily operations?

No. Professional checkers do their job with minimal disturbance and often use digital ways to do so.

What areas are typically reviewed in a compliance audit?

Look at billing and coding, keeping patient info private (that’s HIPAA), and sticking to what the payment folks (payers) and the government (CMS) say you can do.

How often should a medical practice undergo a compliance audit?

You ought to review your work every year, although perhaps more often if you’ve had issues with the rules in the past or made significant changes in your business.

Why does my medical practice need a compliance audit?

To play by these rules of healthcare, avoid expensive fines, needlessly complex administrative and bureaucratic hurdles, and truthful claims.

Schedule Your Compliance Audit Today

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