Audit detail
Full-cycle healthcare billing audit
A structured review of billing episodes across charge capture, coding, insurer replies, and write-offs, ending with a ranked findings pack.
Who this review is for
Finance managers, clinic directors, and hospital revenue officers who suspect leakage in outpatient or day-surgery billing — duplicated charges, missed add-ons, or inconsistent coding between clinicians — and need a defensible written record of what went wrong.
Result you receive
A findings register ranked by financial impact and compliance risk, sample worksheets with corrected charge lines, and a 90-day remediation checklist assigned to billing, clinical documentation, and front-desk capture where relevant.
Scope included
- Sampling plan agreed in writing before file access begins
- Review of charge master items tied to the sampled episodes
- Coding consistency checks against clinical notes for the sample
- Insurer rejection and adjustment letters linked to the same period
- Exit briefing with your billing lead (in person in Kwun Tong or by video)
Scope excluded
- Live re-submission of claims to insurers
- Legal representation in disputes
- Full reconstruction of historical ledgers outside the agreed sample window
- Staff hiring or payroll advice
How the work runs
- Briefing — You share facility type, monthly claim volume, and the period to review.
- Access — We agree secure file access (read-only extracts or supervised on-site review).
- Examination — Auditors work through the sample against your fee schedule and coding rules.
- Findings pack — You receive the register, worksheets, and remediation checklist.
- Optional follow-up — A 30-day check-in call to confirm which actions are underway.
Preparation
Please nominate a single contact who can retrieve claim files and explain local coding conventions. Incomplete extracts slow week two more than any other factor.
Pricing basis
Engagements start at HK$48,000 for outpatient clinics with up to roughly 800 claims in the sample window. Larger hospital units and multi-site groups are quoted after the briefing. Fees are informational until a written engagement letter is signed — there is no online checkout.
Next step
Request an audit brief with your facility name, claim volume, and preferred review period.