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Medical Billing Audit Services

Recover Lost Revenue with Expert Medical Billing
Audit Services

When claims are delayed, denials repeat, or payments do not match the work performed, your revenue cycle needs a closer review. The Hamill Group provides RCM audit services to identify billing gaps, underpayments, and A/R issues before they become long-term losses.
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Revenue Performance Review

When claims are delayed, denials repeat, or payments do not match the work performed, your revenue cycle needs a closer review. The Hamill Group provides RCM audit services to identify billing gaps, underpayments, and A/R issues before they become long-term losses.

97%

Clean Claim Rate

100%

Compliance-Focused
Audit Process

Payment Variance Check

Claims, denials, payments, and billing workflows by experts

How Our RCM Audit Process Reviews and Prioritizes Revenue Gaps

As a trusted medical billing audit company, we use a clear RCM audit process to validate billing performance, trace revenue gaps, and turn findings into practical next steps.

Patient Access & Registration

Patient details, insurance coverage, eligibility, authorizations, and upfront collection steps are verified.

Validate Coding & Documentation

CPT, ICD-10-CM, HCPCS, modifiers, and clinical notes are matched to prevent coding gaps and billing errors.

Charge Capture & Claim Submission

Rendered services, entered charges, clean claim rate, payer edits, and claim readiness are checked.

Denial Management Analysis

Denials are grouped by payer, reason, code, and deadline issues to identify repeat causes.

Accounts Receivable (A/R) & Payment Posting

Payments, adjustments, write-offs, and aging balances are compared to find collection delays.

Compliance & Action Plan

Billing risks, payer rules, HIPAA controls, and audit findings are translated into clear fixes to strengthen revenue performance.
Independent Audit Perspective

Make Every Claim, Payment, and Balance Easier to Trace

Most practices do not need another billing report. They need someone to read the problem signs inside it. The Hamill Group turns claim data, denial activity, payment behavior, and A/R movement into a clear view of where revenue is being delayed or missed. Our medical billing audit services help leaders understand which issues need attention first, which payer patterns affect cash flow, and which workflow gaps create recurring problems. Instead of leaving your team with scattered numbers, our RCM audit provides a practical action plan for cleaner claims, stronger follow-up, and better revenue control.

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How THG RCM Audit Findings Improve Revenue Control

Revenue Governance

Why The Hamill Group Looks Beyond Billing Errors

Strong revenue performance depends on more than getting claims submitted. Your practice also needs billing records, payment decisions, denial responses, and write-offs that can be explained with confidence. The Hamill Group helps healthcare leaders bring more control to those decisions through structured RCM audit services. Every finding is organized to support better oversight, stronger internal accountability, and better preparation before payer questions.

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Revenue Governance

RCM Audit Services for Specialty Practices

Specialty claims are not denied for the same reasons. A cardiology test, behavioral health visit, surgery claim, or DME order each carries different coding rules, authorization needs, and payer checks. The Hamill Group audits these specialty-specific risks so practices can find the issues affecting payment.

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Do Not Let Payers Be the First to Find the Problem

Share your practice details, and The Hamill Group will help identify the right RCM audit scope for your billing operation. You will get a clearer starting point before revenue gaps become harder to correct.
  • Audit scope matched to your practice
  • Clear starting point for investigation
  • No pressure, no long commitment
  • Built for healthcare revenue leaders

Deliverables From Our Medical Billing Audit Services

Revenue Leakage Summary

A clear breakdown of where revenue is being delayed, missed, underpaid, or written off without proper visibility.

Denial Root-Cause Report

Recurring denials are grouped by payer, code, and billing step so your team can see what keeps failing.

A/R Aging Breakdown

Open balances are sorted by age, payer, and follow-up risk to show which accounts need faster action.

Payment Variance Findings

Underpayments, incorrect adjustments, and contract mismatches are flagged to identify reimbursement gaps.

Coding Risk Notes

Coding, modifier, and documentation concerns are listed in simple terms to reduce future claim errors.

Corrective Action Roadmap

Audit findings are translated into clear priorities, workflow improvements, and next steps to strengthen revenue control.

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Audit Warning Signs

When Your Practice Needs an RCM Audit

A medical billing audit service becomes important when revenue feels inactive, but reports and payer responses do not explain the real problem.

Denials keep returning without a clear cause.

Payments slow down across specific payers.

Write-offs increase without leadership visibility.

What Healthcare Providers Say About Our RCM Audit Services

Real practice leaders share how The Hamill Group helped identify billing gaps, causes of denials, underpayments, and AR delays through focused RCM audits.
Our orthopedic claims kept being denied for modifier issues, but the pattern was hard to see internally. THG audited our CPT/modifier use by payer and found that documentation did not support the billed service. Their correction plan helped our billing team reduce repeat rework.
Dr. Meli Grant

North Orthopedic Care

We thought one commercial payer was simply paying according to the contract. The audit showed a consistent underpayment pattern across several procedure codes. They compared our EOBs, fee schedule, and posting records and then provided us with a clear appeal file.

Dr. James Rowland

Lakeside Gastroenterology Group

Our orthopedic claims kept being denied for modifier issues, but the pattern was hard to see internally. THG audited our CPT/modifier use by payer and found that documentation did not support the billed service. Their correction plan helped our billing team reduce repeat rework.

Dr. Anika Patel

BrightPath Behavioral Health

We were losing time on authorization denials for high-value cardiology tests. The Hamill Group traced the issue to missing approval checks prior to claim submission. Their audit showed exactly where our front-end process needed stronger controls.
Dr. Robert Hayes

Summit Cardiology Associates

Our payment posting looked clean until The Hamill Group found write-offs being applied too early. Their RCM audit matched payments, adjustments, and denial notes against payer responses. The findings helped us separate valid write-offs from claims that still needed follow-up.
Dr. Karen Whitmore

Harborview Family Medicine

FAQs

Frequently Asked Questions

What is included in The Hamill Group’s medical billing services?

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

What is included in The Hamill Group’s medical billing services?

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

What is included in The Hamill Group’s medical billing services?

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

What is an RCM audit in healthcare?
An RCM audit is a structured benchmark of a practice’s billing, coding, claims, payments, denials, and A/R performance. It helps identify where revenue is delayed, underpaid, denied, or missed across the full patient-to-payment process.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

Our medical billing services cover eligibility checks, VOB, charge review, CPT/ICD-10/HCPCS validation, 837 claim submission, clearinghouse rejection correction, 835 ERA posting, denial management, AR follow-up, secondary billing, and KPI reporting.

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Stop Losing Revenue Start With a Free Audit

Every month without an audit is another month of unappealed denials, uncaptured charges, and quiet payer underpayments. The Hamill Group helps healthcare practices identify revenue they may have missed, under-collected, or written off too early. Book your free consultation below, and we will return a custom scope within forty-eight hours.
  • Free 30-minute scoping call.
  • Custom scope within 48 hours.
  • Certified CPC and CPMA auditors.
  • HIPAA-compliant from day one.