Medical Audit Services
Uncover errors before they cost you. We audit your coding, documentation, and billing processes for full compliance and revenue recovery.
Introduction
Even the most expert medical practices can have silent revenue leaks or compliance gaps. At Shangrila, our medical audit service helps uncover them before they turn into lost income or penalties. If you need to prepare for an external audit or simply assess internal performance, our process is thorough, fair, and actionable. We review your past claims, medical records, and codes to detect issues like undercoding, overcoding, missed documentation, or improper billing. Our reports help you fix problems now and strengthen your processes for the future.
Key Features
- Sample-based or full audits depending on your needs
- Coding accuracy checks aligned with current payer standards
- Documentation-to-code matching to prevent claim disputes
- Compliance risk assessment with CMS and private insurers
- Detailed audit reports with improvement strategies
Benefits
- Avoid penalties and clawbacks by proactively identifying risks
- Recover missed revenue from underbilled services
- Improve coding habits and provider documentation
- Gain peace of mind before external audits
- Boost compliance confidence across your staff
How It Works
Gather Past Claims and Charts
We review a sample or full batch of billing records.
Audit for Accuracy
Codes, notes, and claims are compared for consistency.
Evaluate Compliance Risks
We flag any regulatory or documentation concerns.
Prepare Detailed Report
You receive a summary of issues, risks, and recommendations.
Support Implementation
We guide you on applying fixes and improving documentation..