Which type of audit is performed before claim submission?

The correct answer is the prospective audit, which is performed before claim submission. This type of audit is designed to assess the documentation and coding processes prior to the submission of claims to payers. The intent is to identify any potential inaccuracies, ensure compliance with coding guidelines, and rectify any issues before the claim is sent. This proactive approach helps minimize the likelihood of claim denials or post-payment audits, which can be time-consuming and may impact revenue cycles.

Prospective audits are essential for maintaining high standards of documentation and compliance, allowing healthcare providers to address any discrepancies in real-time and making necessary adjustments to documentation and coding practices. This not only supports accuracy in billing but also enhances the overall quality of patient care by ensuring that all services provided are properly documented and justified.