AJHC Financial Partners can provide an independent and objective view into your organization’s financial and non-financial activity or reporting to Governmental agencies, Managed Care companies, private organizations and other key stakeholders. These services are designed to add value to the organization with emphasis on constructive improvement of its operations. Our experienced professionals are great at understanding regulations and policies contracts, medical coding reading the numbers and financial reports. We perform COMPLIANCE, PERFORMANCE, INTEGRATED and INFORMATION TECHNOLOGY audits.
At the end of each project AJHC team will produce reports that are independent and objective, ensuring that the company’s risk management practices, internal controls, and corporate governance (business performance, compliance with laws and regulations and ethics) are operating in due form.
AJHC’s audit team helps organizations accomplish their objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of existing risk management, accounting processes, internal controls, and corporate/clinical governance processes.
These audits are held on behalf of management teams and supply tools necessary to improve operational efficiency by identifying problems and correcting lapses before they are discovered in an external audit. We provide all of this while finding solutions to improve performance and revenue cycle.
Internal controls are an important first line of defense against potential fraud, waste, or abuse, as well as possible unintentional non-compliance and violations of existing provisions.
AJHC Financial Partners works with you as an outside party to provide independent objective expertise to remove any bias in reviewing the state of your company’s financials and other reports and documents.
Our audit team will seek to identify if there are any material misstatements in the financial statements and provide a clean opinion to internal (e.g., board of directors, investors) and external (e.g., financial institutions, appeal/arbitration) stakeholders to make better, more informed decisions related to the audited area.
This type of audit may also be performed on behalf of Government Agencies as a performance or compliance review, or to provide subject matter expertise for arbitration and remediation purposes.
Assessment of billing accuracy, coding compliance, and reimbursement methodologies to identify revenue leakage, regulatory risks, and optimization opportunities.
A comprehensive, cross-functional approach that aligns financial, operational, billing, and compliance reviews to provide a complete, accurate view of organizational performance, risk, and opportunity.
Across different industries, companies need to abide by certain regulations and face regulatory compliance while maintaining operational efficiency. Internal controls are an important first line of defense against fraud, non-compliance and violations of provisions.
AJHC’s Audit team helps organizations accomplish their objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of existing risk management, accounting processes, internal controls, and corporate/clinical governance processes. As internal auditors, we act on behalf of the management teams. The emphasis is pushed to ensure compliance with laws and regulations and help to maintain accurate and timely financial reporting and data collection.
These audits also provide the management team with the necessary tools to improve operational efficiency by identifying problems and correcting lapses before they are discovered in an external audit. We provide all of this while finding solutions to improve performance and revenue cycle.
Internal audits play a critical role in a company’s operations and corporate governance, especially now that the Sarbanes-Oxley Act of 2002 holds managers legally responsible for the accuracy of their company’s financial statements. SOX also required that a company’s internal controls be documented and reviewed as part of its external audit. [Congressional Research Service. “Corporate Responsibility: Sarbanes-Oxley Act of 2002,” Pages 5-8].
In addition to ensuring that a company complies with laws and regulations, internal audits also provide a degree of risk management and safeguard against potential fraud, waste, or abuse. The results of internal audits provide management with suggestions for improvements to current processes not functioning as intended, which may include information technology systems as well as supply-chain management. Internal audits may take place on a daily, weekly, monthly, or annual basis. Some departments may be audited more frequently than others. For example, a manufacturing process may be audited on a daily basis for quality control, while the human resources department might only be audited once a year.
Almost all companies receive a yearly audit of their financial statements (such as the income statement, balance sheet, and cash flow statement) or governmental reporting (for funding, grants, contracting).
Audits performed by outside parties can be extremely helpful in removing any bias in reviewing the state of a company’s financials. Lenders often require the results of an external audit annually as part of their loan agreement. For some industries, audits are a legal requirement due to the high occurrences of misstating financial and other reporting information. An impartial auditor’s opinion provides stakeholders with confidence that the financials are both accurate and complete, leading to better, more informed decisions related to the audited company or activity.
The biggest difference between an internal and external audit is the concept of independence of the external auditor. Internal audit reports are primarily used by a company management to improve company operations and prepare for an external audit, where reports are primarily used by outside parties to satisfy a reporting requirement or to be used in arbitration/ independent review processes. Internal audits may be less formal with blurred structure in the form of a casual guidance. External audits are often formal procedures with defined boundaries and disallowed services, as prescribed by the auditing authorities, such as the Generally Accepted Auditing Standards (GAAS) set by Auditing Standards Board (ASB) of the American Institute of Certified Public Accountants (AICPA). Additional rules for the audits of publicly traded companies are made by the Public Company Accounting Oversight Board (PCAOB), which was established as a result of SOX in 2002. A separate set of international standards, called the International Standards on Auditing (ISA), were set up by the International Auditing and Assurance Standards Board (IAASB).
In today’s complex healthcare and reimbursement environment, organizations must balance accurate revenue capture with strict regulatory compliance. Billing errors, coding inconsistencies, and misalignment with payer-specific reimbursement methodologies can result in significant revenue leakage, compliance exposure, and operational inefficiencies. A structured review of revenue cycle processes is essential to ensure that services are accurately documented, coded, and reimbursed in accordance with applicable regulations and contractual requirements.
AJHC Financial Partners conducts comprehensive Revenue Performance & Compliance Audits to evaluate the integrity of billing and reimbursement practices across the organization. Our approach focuses on validating medical coding (CPT, HCPCS, ICD-10, NCCI), assessing documentation support, and ensuring alignment with Medicare, Medicaid, commercial payers, and No-Fault / Workers’ Compensation fee schedules and reimbursement methodologies. We analyze denial patterns, payer behavior, and adjudication outcomes to identify systemic issues impacting revenue realization and compliance.
These audits are designed to detect underpayments, overpayments, missed revenue opportunities, and billing irregularities, contracting and credentialing issues. At the same time, we assess internal workflows related to charge capture, documentation, and claims submission to identify process gaps that may contribute to financial loss or regulatory risk.
Beyond identification of issues, AJHC provides actionable, data-driven recommendations to improve revenue capture, strengthen compliance frameworks, and enhance operational performance. Our goal is to equip leadership with clear insights and practical solutions that support accurate reimbursement, reduce exposure, and drive sustainable financial outcomes.
