Medical Billing, Coding & Compliance Audits
Find Revenue Gaps. Identify Risk. Strengthen Your Practice.
Every part of the revenue cycle is connected. Problems with patient registration, eligibility, authorizations, credentialing, coding, documentation, claims, denials, or collections can affect reimbursement and create unnecessary risk.
Since 2001, Peregrine Healthcare has helped physician practices evaluate revenue cycle performance and identify opportunities for improvement. Our medical billing, coding, and compliance audits provide an objective review of key processes, clear findings, and practical recommendations for what to address next.
A Practice-Wide Look at Your Revenue Cycle
Successful reimbursement depends on processes working together across the revenue cycle.
Depending on the scope of the audit, Peregrine may evaluate:
Patient Registration & Demographics • Eligibility & Benefits • Prior Authorizations • Credentialing & Payer Enrollment • Coding & Documentation • Charge Capture • Claims Submission • Payment Posting • Denials & Appeals • Accounts Receivable • Patient Collections • Reporting & Analytics
This broader approach helps identify where revenue may be delayed, lost, underpaid, or placed at unnecessary risk.
Revenue Cycle & Medical Billing Audits
A revenue cycle audit evaluates the financial and operational processes that move revenue through your practice.
Our review may include:
• Practice and billing workflows
• Revenue and accounts receivable
• Denials, adjustments, and write-offs
• Payer reimbursement trends
• Patient collections
• Eligibility and authorization processes
• Credentialing and enrollment concerns
• Charge capture and claims processes
• Reporting and revenue cycle performance
Findings are presented with identified concerns, opportunities for improvement, and recommended next steps.
Medical Coding Audits
When coding or documentation concerns are identified, Peregrine can perform a focused medical coding audit using a selected sample of patient encounters.
Reviews may evaluate:
CPT® • ICD-10-CM • HCPCS • E/M Coding • Modifiers • Documentation Support • Medical Necessity • Undercoding • Overcoding • Unbundling • Coding Trends
The goal is to identify coding and documentation inconsistencies that may affect reimbursement, denials, or compliance and provide education where appropriate.
Compliance Reviews
Billing, coding, documentation, payer requirements, and internal workflows can all create areas of compliance risk.
Peregrine can evaluate selected areas of your revenue cycle and operations to help identify potential vulnerabilities, inconsistent processes, documentation concerns, and opportunities for corrective action or education.
When Should You Consider an Audit?
You don’t need to wait until there is a serious problem.
An audit may be valuable when your practice experiences:
Rising Denials • Aging A/R • Declining Collections • Reimbursement Changes • Coding or Documentation Concerns • Payer Issues • Staffing Turnover • New Providers or Services • Limited Revenue Cycle Visibility
Periodic reviews can also help identify issues before they become larger financial or compliance concerns.
What Happens After the Audit?
Finding the issue is only the beginning.
Peregrine provides detailed findings and practical recommendations and can work with appropriate staff and providers on education, process improvement, and corrective strategies when needed.
Because Peregrine also supports revenue cycle management, coding, credentialing, payer contracting, patient access, and practice operations, we can help address many of the underlying issues identified during the audit.
Why Peregrine?
Healthcare Experience Since 2001
Decades of hands-on experience across revenue cycle management, medical billing, coding, and healthcare operations.
Certified Coding Expertise
Our team includes AAPC-certified coding professionals with experience across complex medical specialties.
A Practice-Wide Perspective
We look beyond individual claims to understand how patient access, coding, billing, payers, A/R, and collections work together.
Findings You Can Act On
Clear findings, education, and practical recommendations help your team understand what needs attention and what to do next.
Frequently Asked Questions
What is a medical practice audit?
A medical practice audit is a structured review of revenue cycle, billing, coding, documentation, and related operational processes to identify potential errors, inefficiencies, revenue opportunities, and compliance risks.
What is the difference between an RCM audit and a coding audit?
An RCM audit evaluates broader revenue cycle performance, including billing, denials, A/R, collections, payer reimbursement, and operational workflows. A coding audit focuses on coding accuracy and whether documentation supports the codes billed.
Can Peregrine perform a focused audit?
Yes. The scope can be tailored to specific concerns, such as coding, documentation, denials, A/R, patient collections, payer reimbursement, or broader revenue cycle performance.
Can Peregrine help correct issues identified during an audit?
Yes. Depending on the findings, Peregrine can provide education and support improvements involving coding, revenue cycle processes, credentialing, payer management, patient access, and practice operations.
Know What’s Happening Across Your Revenue Cycle
Revenue can be lost long before a claim is denied. A comprehensive audit can help identify where your practice may be losing revenue, creating unnecessary risk, or missing opportunities to improve performance.
Request a Medical Practice Audit
📲 877-463-1110
Based in Texas. Trusted by Physicians Nationwide Since 2001.