M-Audits is a Healthcare Services Auditing Company that helps employers with cost containment measures.  We work with you to help you take control of your benefit plans utilizing the M-Audits Medical Bill Review System to assure that claims are properly billed.  Our system combines the experience of highly skilled nurse reviewers and state-of-the-art medical billing software to achieve lower claim costs and improved claims payment accuracy on both hospital and physician bills.  As a result of our thorough review, M-Audits has an extremely low appeal rate for audited claims.

Simply reviewing hospital claims alone does not always address billing errors and overcharges at a level necessary to uncover most discrepancies.  Most TPA’s and Employers do not challenge the accuracy of hospital bills, which results in higher claims expense and increased insurance costs.  For this reason, the M-Audits system reviews medical records, audits each line of the supporting hospital claim itemization, identifies, and adjusts for inaccurately billed items, and provides clients with savings when appropriate.

M-Audits helps entities such as self-funded employers, insurance companies and re-insurers reduce costs by:

  Reviewing physician bills for overpayments
  Auditing hospital bills and physician bills prior to payment
  Deflecting payment of incorrect bills prior to claim adjudication.

M-Audits relies on coding guidelines published by the American Medical Association, using industry standards for ‘usual and customary’ charges.
M-Audits is a member of the Medical Billing Advocates of America (MBAA) whose mission is to contain costs by requiring providers to submit proper bills.

WHAT THIS MEANS TO YOU . . .

M-Audits is committed to helping you control your medical expenses by making sure that you pay only for charges that are reasonable and accurate.  M-Audits routinely examines hospital bills for inappropriate charges, such as unbundling of codes, up-coding of charges, and more.  These items have proven to be a major contributor to rising healthcare costs.

The savings generated from these audits is a significant savings to your bottom line and helps to maintain the financial stability of your health plan.