Billing errors, coding mistakes, missed charges, wrong modifiers, cost your practice thousands every year. A medical billing audit identifies revenue leakage, compliance gaps, and process inefficiencies before they become permanent losses.
That’s why you need a medical billing audit.
PracticeMate’s medical billing audit services dig deep into your revenue cycle claims, coding, documentation, payer payments, and compliance to find exactly where your money is going and how to get it back.
The word “audit” makes most practice owners nervous. But this is different. This is a revenue recovery audit, not a government investigation. We’re not looking for penalties. We’re looking for money.
Here’s what we find in almost every audit:
The average practice recovers $15,000-$50,000 from a comprehensive audit. But more importantly, you fix the process and prevent future losses.
We provide patient billing support for every type of healthcare practice.
| Who | Why |
|---|---|
|
You’ve never had one |
You don’t know what you don’t know. First-time audits find the most revenue. |
|
Your revenue is flat or down |
Something changed. You need to find what. |
|
Denials are increasing |
Denial patterns suggest coding or process issues. |
|
You’re growing |
More patients, more claims, more risk of errors. |
|
Payer contracts changed |
Underpayments are common after contract changes. |
|
New staff or system |
New people or software = new error opportunities. |
|
You want to sell or merge |
Clean revenue cycle increases practice value. |
We don’t just review claims. We dig into the whole revenue cycle from the moment the patient schedules to the final payment posted.
Here’s what that looks like:
We pull your claims data, EOBs, and sample documentation. No disruption to your practice.
Our certified coders review claims, codes, modifiers, documentation, and payments. We identify errors, patterns, and opportunities.
We calculate how much revenue you’re losing. Not estimates. Actual dollars.
We deliver a clear, actionable report that shows:
Revenue leakage — total dollars lost
Recovery opportunities — how much we can recover
Process fixes — what needs to change
We help you implement fixes. Or we do it for you with our billing services. Your choice.
Because we audit differently.
| Typical Audit | PracticeMate Audit |
|---|---|
|
Checks a sample of claims |
Reviews patterns across all claims |
|
Finds coding errors |
Finds revenue leakage and compliance gaps |
|
Gives a report you can’t understand |
Gives clear, actionable recommendations |
|
Focuses on what’s wrong |
Focuses on how to fix it |
|
Stops at findings |
Continues to recovery and improvement |
|
One-time exercise |
Part of ongoing revenue integrity |
We learn about your practice, your revenue cycle, and your concerns. We answer questions. No obligation.
We define the audit scope — which services, which payers, which timeframe. We tell you exactly what we'll review.
You give us access to your billing system and sample documentation. We protect your data.
Our team reviews claims, codes, documentation, and payments. We identify patterns and quantify leakage.
We deliver a clear, easy-to-understand report that shows what we found, how much money is at stake, and what to do about it.
We help you implement fixes. Or we do it for you. Your choice.
We’ve audited hundreds of practices. Here’s what we find:
| Issue | % of Practices Affected | Average Revenue Impact |
|---|---|---|
|
Missed charges |
85% |
3-6% of revenue |
|
Underpayments |
78% |
2-5% of revenue |
|
Coding errors |
72% |
2-4% of revenue |
|
Modifier errors |
65% |
1-3% of revenue |
|
Denials not appealed |
60% |
1-3% of revenue |
|
Documentation gaps |
55% |
1-2% of revenue |
Total average revenue leakage: 10-15%
For a practice generating $1,000,000 annually, that’s $100,000-$150,000 in lost revenue. For a $5,000,000 practice, that’s half a million dollars.
FaqsA systematic review of your revenue cycle to identify coding errors, missed charges, compliance gaps, and revenue leakage. Unlike a government audit, a billing audit is voluntary you choose it to find revenue and fix problems before they become bigger issues.
A billing audit focuses on revenue recovery finding missed charges, coding errors, and underpayments. A compliance audit focuses on regulatory adherence, CMS guidelines, fraud risk, and HIPAA. We do both.
No. We work behind the scenes. Your staff continues their regular work. We pull data and find revenue without interference.
2-4 weeks for a typical practice, depending on volume and scope. We work quickly without cutting corners.
We charge based on practice size and scope. Most audits are significantly less than the revenue we recover. We'll discuss pricing during your consultation.
We always find something. No practice is perfect. But if we don't identify at least 2x our fee in recovery opportunities, the audit is free. That's our guarantee.
Yes. Once the audit identifies revenue leakage, we can handle recovery filing corrected claims, appealing denials, and pursuing underpayments. Or we can give you the report and you handle it.
Revenue leakage is money you should have collected but didn't missed charges, underpayments, denied claims not appealed, coding errors, and documentation gaps. Most practices leak 10-15% of revenue.
No. It's a sign of smart management. Good practices audit regularly to prevent revenue leakage and catch issues early.
Yes. Billing companies make mistakes too. An independent audit of your billing company's performance is the best way to ensure they're doing their job.
Your practice works hard to deliver exceptional care. Every dollar lost to billing errors, missed charges, or underpayments is a dollar that should be funding your growth, your staff, and your patients’ experience.
PracticeMate’s medical billing audit services are designed to identify where your revenue is leaking, and provide a clear, actionable roadmap to recover it.
FaqsThree to four weeks for most endocrinology practices. We run parallel processing so claims never stop going out. Practices with DSMT program accreditation work or large open AR balances may take five to six weeks.
No. Guaranteed in writing. If your clean claim rate drops below your previous rate in the first 60 days, we work three months at no charge until we close the gap.
We don't issue accreditation — that comes from ADA or ADCES. We do walk you through the application, documentation, program NPI setup, and the billing structure once you're accredited. If you already have accreditation but aren't billing G0108/G0109, we can start within two weeks.
Yes. We audit your CGM patient panel for RPM eligibility, document the 16-day data threshold, set up time-tracking for 99457/99458, and bill monthly. Most practices haven't billed RPM at all — we typically recover six months of eligible RPM revenue in the first 90 days.
Yes. We bill under your NPI and Tax ID. No re-credentialing. No re-enrollment. If you have open credentialing in progress, we manage it as part of onboarding at no additional charge.
Yes. We execute a Business Associate Agreement (BAA) before accessing any patient record. Encrypted transmission. Access-controlled environments. HIPAA-auditable pipeline.
Percentage based on collections. We are paid when you are paid. No flat monthly fees. No per-claim fees that reward volume over accuracy. Written fee proposal before any agreement is signed.
