Prefer it online? Patients fill it out on their phone before the visit.
Practice name: ______________________________
Medical Billing Audit Questionnaire
Practice/Facility Name
Audit Date Range
____ / ____ / ________
Billing Software System
Total Monthly Claims Volume
Certified Coders on Staff
Primary Payer Mix
Clean Claims Rate
Days in A/R
Medical Billing Audit Questionnaire template from formisoft.com. formisoft.com/intake-templates/medical-billing-audit-questionnaire