Audit Focus

At Buraq Medical Billing, we recognize that healthcare providers work tirelessly to deliver the best possible care to their patients. However, this dedication can only be fully effective if their medical billing team—whether in-house or outsourced—is operating efficiently and in sync with the practice. Providers often have demanding schedules and limited time to delve into the complexities of their billing operations. Yet, overlooking this critical aspect can lead to serious financial setbacks. The purpose of our audit is to provide a comprehensive overview of your practice’s revenue cycle management. This process involves an in-depth analysis to pinpoint gaps in your billing workflow, highlight problem areas, detect inefficiencies in charge capture, and uncover issues within accounts receivable and other key components. Buraq Medical Billing is here to ensure your practice remains financially healthy and fully optimized.

Practice Gains

Healthcare providers often know what’s being deposited into their bank accounts, but they may not realize what revenue is being missed. While standard AR reports offer a glimpse, they rarely reveal the full picture of the challenges a practice may be facing. An audit conducted by Buraq Medical Billing provides clear visibility into existing issues within the revenue cycle. Our detailed findings and recommendations can significantly enhance performance, helping providers understand exactly where their practice stands and how to optimize its financial health.

Standard Procedure

Once an audit is initiated, Buraq Medical Billing Inc. follows a structured and thorough process: Generate Reports: We begin by running key reports—such as accounts receivable, scheduler, patient balances, and insurance payments—to gain a comprehensive understanding ofthe practice’s financial status.

Extract and Analyze Sample Data: After gathering the reports, we select specific time periods, claims, and patient accounts to create a representative data sample. This sample is carefully analyzed to identify trends, discrepancies, or issues.

Claims Follow-Up: We contact insurance companies to verify the status of every pending claim in the sample. All findings are documented thoroughly, with detailed notes and actionable recommendations for resolution.

Verify Payer Enrollment Status: Verifying the provider’s enrollment with all payers is essential, as it directly impacts reimbursement. We ensure the provider is properly enrolled with each insurance company to avoid delays or denials.

Fee Schedule Review for Paid Claims: Fee schedules are typically entered during the setup of the practice management system. If configured incorrectly, it can lead to underpayments (resulting in lost revenue) or overpayments (risking a CMS audit and potential payment holds for up to two years). We review and validate the fee schedules applied to ensure accuracy.

Practice Management Software Configuration: To maximize efficiency, we audit the configuration of your practice management software. Our goal is to ensure it is correctly set up, optimized, and fully utilized for effective billing operations.

Audit Findings Summary

After completing all the audit procedures, we compile a detailed analysis summary that outlines key findings and insights. This summary highlights critical issues affecting the practice, such as the number of claims not on file, those that missed the filing deadline, and the percentage of claims paid, denied, or written off as losses.

Each identified issue is accompanied by recommended corrective actions to help improve future performance. The summary is data-driven, featuring clear facts, figures, and visual charts that provide a comprehensive view of the practice’s billing healthand overall financial condition.

Audit Trail Report

The detailed report provides a complete audit trail of the reviewed sample data. It includes all actions taken on each claim, responses received from insurance representatives, and a thorough record of findings, issues, and discrepancies identified during the audit process.