MEDICAL BILLING AUDIT

Find Revenue You Did Not Know You Were Losing

CureMed's billing audits dig into your claims data to uncover underpayments, coding errors, missed charges, and compliance gaps. You get a clear breakdown of where revenue is leaking and a concrete plan to recover it.

HIPAA CompliantNo Obligation
CureMed billing audit dashboard showing revenue recovery opportunities and coding accuracy metrics
12+
Years running
20+
U.S. states served
30+
Specialties billed
96%
Clean claim rate
3.99%
Flat rate, no minimum

Most Practices Are Losing Revenue Without Knowing It

Billing errors, undercoding, missed charges, and payer underpayments accumulate quietly over time. Without regular audits, the losses compound.

  • 5 to 10%

    of practice revenue is lost annually due to coding errors, missed charges, and billing inefficiencies that go undetected without a formal audit.

  • 30%

    of claims contain errors that reduce reimbursement, including undercoding, incorrect modifiers, and missed billable services.

  • $125K+

    is the average annual cost of employing one in-house billing specialist. An audit often recovers more than that cost in the first review alone.

A billing audit is not about finding blame. It is about finding money your practice has already earned but never collected.

How Our Billing Audit Works

A structured, five-step review from data collection to actionable recovery plan.

  1. 01

    Data Collection & Scoping

    We gather claims data, remittance records, payer contracts, and coding reports. You define the scope: full practice, specific payers, or targeted date ranges.

  2. 02

    Claims & Coding Analysis

    Our audit team reviews claim submissions for coding accuracy, modifier usage, charge capture completeness, and documentation alignment.

  3. 03

    Payer Reimbursement Review

    We compare actual payments against contracted rates to identify underpayments, incorrect adjustments, and missed contractual obligations.

  4. 04

    Compliance & Risk Assessment

    We evaluate coding patterns for compliance risk, upcoding exposure, and documentation gaps that could trigger payer audits.

  5. 05

    Findings Report & Action Plan

    You receive a detailed report quantifying lost revenue, identifying root causes, and providing a prioritized action plan for recovery and prevention.

Most audits are completed within 2 to 3 weeks. Preliminary findings are available within 72 hours.

What's Included in a CureMed Billing Audit

A comprehensive review covering every stage of your revenue cycle where money can be lost.

Coding Accuracy Review

Line-by-line analysis of CPT, ICD-10, and HCPCS code assignments to identify undercoding, overcoding, and missed billable services.

Charge Capture Analysis

Cross-referencing scheduled appointments, clinical documentation, and submitted claims to find services that were delivered but never billed.

Modifier Compliance Check

Review of modifier usage across all claims to identify patterns causing denials, downcoding, or bundling rejections.

Underpayment Detection

Comparison of actual reimbursements against payer contract rates to identify systematic underpayments and incorrect adjustments.

Denial Pattern Analysis

Root cause breakdown of denial trends by payer, procedure, and denial reason code to identify preventable patterns.

Compliance Risk Assessment

Evaluation of coding patterns for regulatory risk, including potential upcoding flags, documentation gaps, and audit exposure.

Payer Contract Review

Analysis of fee schedules and reimbursement terms to ensure your contracts reflect current market rates and are being honored by payers.

Actionable Recovery Report

A prioritized report with specific dollar amounts recoverable, root causes identified, and step-by-step recommendations for prevention.

Why Choose CureMed for Billing Audits

We do not just hand you a report. We quantify lost revenue, identify root causes, and give you a clear plan to recover it.

Dollar-Specific Findings

Every finding includes the specific dollar amount at risk or recoverable. No vague percentages or general recommendations. You know exactly what is on the table.

Specialty-Aware Auditors

Our audit team includes coders with specialty-specific expertise across 200+ specialties. They know what correct billing looks like for your practice type.

Payer Contract Benchmarking

We compare your reimbursements against contracted rates and market benchmarks to identify underpayments you may have accepted as normal.

Prevention, Not Just Detection

Every audit report includes workflow recommendations and process fixes to prevent the same errors from recurring after recovery.

Where Revenue Slips

Most practices leak between 8 and 12 percent of collectible revenue

You never see it, because it looks like ordinary denial noise. This is where we usually find it.

1st

Undercoding

Providers documented a level higher than what was billed. Common on 99213 against 99214 splits.

2nd

Missed modifiers

Modifier 25, 59 and 79 dropped from claims that would have been paid separately.

3rd

Aged AR

Claims past 90 days quietly written off instead of appealed. Money left on the table.

4th

Eligibility gaps

Denials that started at the front desk. Wrong plan, expired coverage, missing prior auth.

How The Audit Works

Four steps, one week, no cost

You send the data, we do the work, you get a written report. Whether you switch to us afterwards is entirely up to you.

  1. 1Day 1

    You share the data

    Three months of claims and denials, exported from your PM system. We send a secure upload link.

  2. 2Day 2 to 5

    We review everything

    Certified coders go through each claim: coding, modifiers, denials by payer, and aging patterns.

  3. 3Day 6

    We write it up

    A plain English report with leakage estimates, specific claim examples, and recommended fixes.

  4. 4Day 7

    Walk-through call

    Thirty minutes on the phone. We answer questions and hand over the report. No follow-up pressure.

What Is In The Report

Six things every audit report includes

Real numbers from your practice, benchmarked against your specialty. Not a generic deck.

  • Revenue leakage estimate

    A dollar figure showing what you are likely losing every month right now.

  • Denial breakdown

    Sorted by payer and reason code, so you can see which battles to pick first.

  • Coding accuracy score

    A sample review of E/M codes, procedure codes, and modifier use, benchmarked to your specialty.

  • Aging AR analysis

    Buckets at 30, 60, 90, and 120 plus days, highlighting the claims still worth chasing.

  • Clean claim rate

    Your first-pass acceptance rate against industry and specialty medians.

  • Specific recommendations

    Not vague advice. Concrete fixes with example claim numbers you can act on today.

Live sample
Sample audit report
Cardiology practice, Texas
Estimated monthly leakage
$18,400
Denial rate
7.8%
Clean claim rate
81%
Days in AR
52 days
Top denial reason
CO-16 missing info
Projected recovery
+$220K a year

Yours to keep either way

Whether you work with us or not, the report is yours. Take it to your current biller and use it as ammunition. Share it with your partners. Sit on it. We are not going to keep chasing you because you did not sign a contract.

$290K
Recovered from written-off AR
In the first quarter alone
CureMed's audit found $340K in recoverable revenue we had no idea we were leaving on the table. The report was detailed, specific, and gave us a clear roadmap to fix everything.
Dr. David ChenManaging Partner
Specialties Covered

Billed across every specialty we cover

Coders who work your specialty daily, not generalists reading a manual. Same rate whichever one you are.

Frequently Asked Questions

Frequently Asked Questions

Yes, external audits provide objective insights and detect issues internal teams might overlook, enhancing revenue cycle integrity.

CureMed identifies billing errors, compliance risks, and process gaps, recommending corrective actions to maximize reimbursements and reduce liabilities.

Without audits, providers risk overpayments, claim denials, compliance violations, and delayed or lost revenue.

Audits review coding accuracy, claim submissions, insurance verification, payment posting, denials, and appeals management.

Audits are recommended at least annually, with larger practices performing them quarterly for optimal compliance and revenue health.

Ready to see what cleaner billing looks like for your practice?

CureMed's billing audits dig into your claims data to uncover underpayments, coding errors, missed charges, and compliance gaps. You get a clear breakdown of where revenue is leaking and a concrete plan to recover it.

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