Healthcare billing audit

Healthcare billing audit: complete invoices before they are filed.

We review your invoices before they are sent to insurers, so they arrive with the right support, rates and RIPS records and objections go down. More than 30 years of experience, backed by PA Global Network.

Request a proposal See how we work
Billing auditor reviewing invoices with a clinic's billing coordinator
Member of PA Global Network
A Forum of Firms network
Res. 2275e-invoicing and RIPS
Receivablesrecovery of objections
EN · ESreports in two languages
30+years of experience
What it is

Fewer objections, more receivables recovered.

Most objections stem from billing errors: incomplete support, wrong rates or inconsistent RIPS records. A billing audit catches them before filing and helps recover what has already been objected to.

When you need it

  • You face frequent objectionsor returns due to missing support.
  • Receivables from insurersare growing and aging.
  • You are implementing changesto electronic invoicing or RIPS.
  • You are renegotiating contractsand need reliable figures.
What we review

What we review in billing.

We focus on the most common causes of objections and returns.

01

Supporting documents

Clinical record, authorizations, orders and results backing the invoice.

02

Rates

Application of the rates agreed in each contract.

03

RIPS

Consistency of the individual service records.

04

Electronic invoicing

Requirements of the healthcare sector electronic invoice.

05

Objections received

Causes, responses and recovery of objections.

06

Receivables

Reconciliation of balances with each insurer and aging.

Auditor checking an invoice against the rate schedule
How we work

Before filing and after the objection.

We work at both stages: preventing billing errors and helping recover what was objected to.

  1. 1DiagnosisWe analyze recent objections and their causes by insurer and concept.Resolution 2284 of 2023
  2. 2Pre-filing reviewWe review samples of invoices before they are filed.Resolution 2275 of 2023
  3. 3Responding to objectionsWe support responses to objections with evidence.Single objections manual
  4. 4Receivables reconciliationWe reconcile balances with insurers and prioritize recovery.Reconciliation
What you receive

Invoices that get paid.

  • A diagnosis of objection causes by insurer and concept.
  • Invoices reviewed before filing, with observations.
  • Responses to objections with supporting evidence.
  • Receivables reconciliation and a recovery plan.
Request a proposal
Auditor explaining billing findings to a clinic's finance director
FAQ

What you should know.

What is a healthcare billing audit?

It is a review of a provider's invoices to verify that they have the right support, rates, RIPS records and electronic invoicing requirements before they are filed.

Do you help recover disputed receivables?

Yes. We review objections received, prepare supported responses and support reconciliation with insurers.

Which regulations apply?

Ministry of Health Resolution 2275 of 2023 on electronic invoicing and RIPS, and Resolution 2284 of 2023 on the single manual of returns, objections and responses.

Do you review every invoice?

We can review all invoices or samples depending on volume, prioritizing those with the highest value and risk.

How is it different from a medical claims audit?

A billing audit is done from the provider's side before filing; a medical claims audit is done from the insurer's side before payment.

Other healthcare audit services

Services that work together.

See the full healthcare audit line →

How much are objections costing you?

Tell us your billing volume and a partner will send you a proposal.

Talk to a partner Contact form

Billing Audit of Health Services

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Billing Audit of Health Services : focused on the suppression of under- or over-invoicing application of the general administrative checks and medical .