What does a prospective audit refer to?

A prospective audit refers to the process of evaluating patient records before any billing occurs. This proactive approach is designed to ensure that documentation is complete and accurate, allowing for appropriate billing practices and compliance with regulations before claims are submitted to insurers. Conducting a prospective audit helps identify any discrepancies or areas for improvement in medical records and billing documentation, ultimately minimizing the risk of claims denials and ensuring adherence to coding and billing guidelines.

The other options describe different types of audit processes, such as retrospective audits, which analyze claims post-payment, or reviews focused on external competitors, which are not aligned with the definition of a prospective audit.