What is Medical Auditing?
The definition of an audit is: To conduct an official examination of an individuals or organizations account
(s). That is exactly what a Medical Audit is. Auditing medical records is an important factor in keeping
doctors and medical facilities compliant on the rules and regulations that pertain to the medical field.
Medical Audits are performed for a multitude of reasons, some of which include (but not limited to); to
ensure fraudulent claims and billing activities are compliant, to prevent out-of-date and false codes from
being utilized, and to pinpoint and resolve mistakes to prevent government or insurance agencies from
paying incorrect claims.
A medical auditor conducts a medical audit to provide checks and balances to ensure all billing
documentation is correct. Medical audits can be performed monthly, once every quarter, or annually. Most
companies will conduct their own medical audits, whether it be with an outside contractor or in house, to
ensure accurate coding and billing is being met and/or prior to a governmental audit. Medical auditing is
only one factor in the medical coding process.
Are you intrigued? MCHC offers online and live classes to teach you everything you need to know to
become a certified medical auditor You’re new career path is one click away!