What is the primary focus of auditing claims?

The primary focus of auditing claims centers on validating coding and capturing charges. This process is vital to ensure that the services provided are accurately represented in the medical coding. Proper coding not only affects billing and reimbursement but also plays a critical role in compliance with regulations and the overall integrity of health records. By verifying that the codes correspond to the services rendered and are in alignment with documentation standards, auditing helps mitigate the risk of revenue loss and potential legal issues.

While reducing operational costs, ensuring service quality, and increasing patient satisfaction are important aspects of a healthcare organization, they are not the main focus of auditing claims. Instead, the fundamental purpose of an audit is to confirm that all aspects of coding and charge capture are correct, thereby supporting the financial health of the practice.