Audits can be stressful, time-consuming, and financially risky for healthcare providers. At 5 Star Billing Services, we stand beside you with reliable, compliant, and specialty-focused Audit Support in all 50 states. Whether it’s documentation reviews, payer audits, recoupment prevention, or compliance guidance, our experts ensure you’re fully prepared, accurately represented, and protected from costly errors.
Providers are facing more payer audits than ever—Medicare, Medicaid, RAC, CERT, and commercial payers constantly reviewing documentation and claims.
Payers often take months to process applications, and without constant follow-ups, approvals get pushed even further.
Unexpected audit findings can lead to paybacks, penalties, or delayed reimbursements that disrupt cash flow.
Many practices don’t have certified auditors or compliance specialists to navigate complex federal and payer rules.
Responding to audit requests takes hours—pulling charts, preparing documentation, creating appeal letters—taking providers away from patient care.
HIPAA, CMS guidelines, payer-specific policies, and specialty protocols add pressure and uncertainty.
With over 40+ specialties, each requires unique documentation standards—often overwhelming for in-house teams.
We perform proactive chart audits, documentation reviews, and coding accuracy checks to ensure your practice is audit-ready at all times.
RAC, MAC, CERT, ZPIC/UPIC, Medicare Advantage, Medicaid, and commercial payer audits—our team handles them all with precision.
Our AAPC- and AHIMA-certified experts ensure accurate coding, compliant documentation, and proper billing workflows for every specialty.
We identify gaps and help providers improve note templates, encounter forms, and EHR documentation for stronger audit defense.
From gathering records to drafting response letters and appeals, we manage the entire process so you stay focused on patient care.
Our approach minimizes denials, prevents paybacks, and protects providers from unnecessary financial losses.
We support 40+ specialties, including cardiology, orthopedics, mental health, pediatrics, neurology, allergy, urgent care, and more—each with tailored auditing support.
We understand state-specific payer rules, Medicaid programs, and compliance regulations.
From complex surgical coding to behavioral health documentation, we tailor our medical coding service for every provider type.
From compliance to collections — we simplify every step of your revenue cycle.
Our clean claim submission process minimizes rejections and accelerates reimbursements — helping you get paid faster with fewer follow-ups.
We follow strict data security measures — encrypted communications, limited access, and full HIPAA adherence.
Through continuous claim tracking, automated reminders, and payer-specific workflows, we ensure quicker payment cycles and improved cash flow.
By identifying missed charges, underpayments, and coding errors, our audit-backed billing process boosts your overall collections.
We ensure claims are processed within 1–2 business days after receiving the patient encounter data — reducing delays and denials.
We work with major systems like AdvancedMD, Athenahealth, Epic, Tebra, and DrChrono — no need to switch platforms.
Our team follows the latest CPT, ICD-10, and HCPCS updates to maintain coding accuracy and compliance with payer rules.
From cardiology and allergy to behavioral health and urgent care — we understand each specialty’s coding and billing nuances.
Every client gets a single point of contact to ensure personalized support, clear communication, and faster issue resolution.
From patient eligibility verification to AR follow-up, denial management, and payment posting — we handle the entire revenue cycle.
We conduct periodic internal audits and follow CMS, OIG, and payer compliance guidelines to minimize regulatory risks.
Flexible engagement — scale up or pause anytime. We earn your trust through results, not lengthy commitments.
Double-verification at every stage ensures precise data entry, claim validation, and payment posting accuracy.
We understand payer variations across all 50 U.S. states — including Medicaid, Medicare, and commercial insurance carriers.
Monthly or weekly performance reviews keep you informed about KPIs like collection rates, denial ratios, and revenue growth.
Join hundreds of practices experiencing measurable improvements
Holmes Chiropractic
Medical Director
Medical Director, Pulmonary & Sleep Associates of Marin
Everything you need to know about outsourcing your medical billing
We handle all major payer and federal audits, including RAC, MAC, CERT, ZPIC/UPIC, Medicare Advantage, Medicaid, private commercial insurance audits, medical necessity reviews, and targeted probe audits. Our team manages the full process—from preparation to appeals.
We conduct proactive chart audits, coding accuracy checks, and documentation reviews to ensure your practice stays audit-ready. This includes identifying risks early, correcting patterns, improving documentation, and strengthening compliance to prevent future findings.
Yes. We offer full Audit Response Management, including pulling medical records, preparing audit packets, drafting response letters, communicating with payers, and coordinating appeal submissions if needed. Your staff can stay focused on patient care while we handle the heavy lifting.
Absolutely. We provide specialty-focused audit support for 40+ specialties, including cardiology, orthopedics, neurology, mental health, pediatrics, allergy, urgent care, family medicine, and more. Each specialty receives tailored documentation and coding guidance.
Yes. Our auditing and compliance team includes AAPC- and AHIMA-certified medical coders, auditors, and billing specialists with extensive experience in multi-specialty audit defense and payer compliance.
Yes. We focus heavily on risk reduction and revenue protection by ensuring accurate documentation, compliant coding, proper medical necessity support, and strong appeal responses. Our goal is to limit or eliminate recoupment requests.
We prioritize audit cases immediately. Our team can begin same-day document collection, coding review, and response preparation, ensuring payers receive timely and complete submissions before deadlines.
We provide post-audit analysis, correct any documentation or coding issues, implement corrective action plans, and perform follow-up audits to ensure long-term compliance and prevent repeat findings.
Yes. Our Continuous Compliance Monitoring Program includes regular pre-bill audits, fraud-waste-abuse safeguards, annual reviews, note template optimization, and specialty-specific documentation training for your providers.
Yes. We provide nationwide audit support across all 50 states, including state-specific Medicaid programs, commercial payer rules, local coverage determinations (LCDs), national guidelines, and specialty-specific regulatory requirements.
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