What is meant by an audit in medical billing and coding?

An audit in medical billing and coding refers to a systematic review of billing practices to ensure compliance with regulations, guidelines, and coding standards. This process is essential for verifying that the services billed to insurers and patients are justified by the corresponding documentation in patient health records. Auditors assess whether the coding corresponds accurately to the clinical services provided and that all applicable billing laws and guidelines are followed.

An audit helps organizations identify areas for improvement, prevent fraud, and reduce the risk of billing errors, which can lead to denied claims or legal penalties. It ensures that the healthcare provider is receiving appropriate reimbursement for services rendered while also maintaining accountability and transparency in the billing process.

The other options focus on different aspects of healthcare management, such as examining patient records or assessing financial performance, but they do not capture the specific purpose and scope of an audit in the context of medical billing and coding.