General Category > General Questions

RCM Audit

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Billingbilling:
Any on here perform, or know someone that performs, RCM audits? Another biller was asking me for their client but I don't do them.

Basically wants someone to review the collections ratios, aging, etc... to make sure there biller is doing a good job.

PMRNC:
It should be an outside service with contractual obligations ONLY to the provider with no interaction between the biller/billing company. I usually will refer my clients to a LOCAL business that performs external audit's. A BA is absolutely required and there should be no obligation to the current billing company that it's being done. You will want to also look at your billing company's contract to adhere to any advanced notice they may require. My contract states that a provider will give me 60 days notice of any external audit to be performed and outline all that I am obligated to remit for the audit.

Billingbilling:
Thanks!

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