What is the primary purpose of performing audits in medical billing?

The primary purpose of performing audits in medical billing is to avoid errors in billing and coding. Audits are systematic examinations of billing practices and documentation. They help ensure that claims submitted to insurance companies or government payers are accurate and properly supported by corresponding medical records. By identifying discrepancies or areas of potential error, audits can help healthcare providers correct mistakes before claims are submitted or before payments are processed, minimizing the risk of denials or penalties.

While audits can indeed lead to improved training opportunities for staff and support compliance with regulations, the foremost goal is the identification and correction of errors. This proactive approach enhances overall billing accuracy and protects the financial interests of both healthcare providers and patients by ensuring that claims reflect the services performed accurately and appropriately.