Medical Billing Analysis Services
That Protect Revenue & Ensure Compliance
Our Medical Billing Analysis Services in USA uncover the hidden reasons for claim denials. We analyze audits of your entire RCM flow, from eligibility to ERA posting, to expose denial patterns and coding gaps. At Avenue Billing Services, we turn billing data into clear action steps that reduce denials, accelerate reimbursements, and restore cash flow.
HIPAA-Compliant Audit Process
Certified ICD-10/CPT Auditors
98% Accuracy Benchmarked
Works Across 30+ Specialties
Get Free Billing Audit
Why Providers Trust Our
Medical Billing Audit Experts
Compliance You Can Trust
Every audit follows CMS,
OIG, HIPAA, and payer policy
guidelines.
Accuracy That Reduces
Denials
Coding, modifiers, ICD-10
alignment,documentation
validation all checked.
Revenue Integrity
Protection
We identify underbilling,
missed charges, and
incorrect reimbursement.
Built for Small & Multi-
Specialty Clinics
Flexible, affordable auditing — no disruption to your workflow.
Comprehensive Billing Audit Services
Coding Accuracy
Audit
ICD-10, CPT,
HCPCS, modifiers,
NCCI/LCD checks.
Documentation &
Medical Review
Validates provider
notes to support
billed services.
Charge
Capture Audit
Identifies missed
charges, duplicate
charges, and
incorrect units.
Claim Accuracy &
Compliance Review
837P/837I, payer
edits, bundling/
unbundling errors
Denial Pattern
Audit
Find root-cause
issues behind
recurring denials.
RCM Workflow
Audit
Eligibility → coding
→ submission → AR
→ posting →
reporting.
A/R & Under
payment Audit
Identifies unpaid
claims and
incorrect payer
reimbursements.
Corrective Action
Planning
Detailed
recommendations,
SOP updates, and
risk mitigation.
Which Type of Medical Billing
Audit Do You Need?
Prospective
(Pre-Bill) Audit
Prevents errors
before claims are
submitted.
Retrospective
(Post-Bill) Audit
Reviews already-
submitted claims for
compliance +
accuracy.
Risk-Based
Audit
Targets high-risk areas such as
E/M coding, modifiers, chronic
care, and specialty-specific
risks.
Full RCM
Audit
Deep re view of your entire revenue cycle — documentation → coding → claims → AR → denial handling.
Our Billing Audit Process
Simple, Transparent Audit Pricing
Most practices pay one flat audit fee based on the sample size and scope.
No hidden charges. No lock-in contracts.
Specialty-Focused Audit
Expertise
Every specialty has unique audit risks — coding levels, documentation
depth, payer rules and medical necessity requirements.
Our auditors are trained across 40+ specialties.
Audit-Ready With Every Major
EHR, PM System & Clearinghouse
Our audit team works directly inside your billing system with accurate
data extraction, clean reporting and zero disruption.
Medical Billing Analysis Services Across the USA
New York
North Carolina
South Carolina
Florida
Alabama
Massachusetts
Why Outsourcing Your
Billing Audit Makes Sense
Lower Compliance Risk
Avoid CMS, OIG, RAC and ZPIC audit exposure.
Higher Reimbursement Accuracy
Fix underbilling, missed charges, and incorrect
payer payments.
Stronger Revenue Integrity
A complete check of your RCM health, from documentation to claim adjudication.
Protect Your Revenue. Reduce
Errors. Stay Compliant.
Get a free audit + detailed error breakdown within 24 hours.
Frequently Asked Questions
A structured review of coding, documentation, claims, and payments to ensure accuracy and compliance.
Upcoding, downcoding, missing documentation, incorrect modifiers, missed charges and duplicate claims.
Certified auditors specializing in ICD-10, CPT, compliance, RCM workflows, and payer policies.
Most practices audit quarterly; high-risk specialties may audit monthly.
Yes, we create a corrective action plan and help implement workflow improvements.
Yes, we can audit any EHR or PM system without disruption.
Yes, Medicare, Medicaid, BCBS, Aetna, Cigna, UHC, and specialty payers.
