If you receive a letter from Medicare about an audit, call your Attorney first....then call us!

Chart Auditing

  • Certified Coding Specialists perform random sampling of patient charts
  • Assesses the accuracy of the coding billed to payers. Appropriate use of Evaluation & Management (E/M) codes ensures accuracy of what was billed to insurance payers is documented which achieves better reimbursement
  • Specialist makes billing recommendations
  • A prospective approach for more efficient coding and billing
  • A vital part of an internal Compliance Plan with a positive boost to eliminate mistakes and avoid accusations of fraud and abuse
  • Routine quarterly audits are recommended
  • Turn the results of an internal audit into a corrective action plan for implementing and monitoring improvements

A Performance Audit involves a series reviews in four (4) general areas – billing data entry, documentation, coding, and charge capture. Other areas of the practice affect reimbursement too. Personnel from appointments, front desk, clinical assistants, check-out, and payment posting all contribute to financial success of any practice. The Performance Audit attempts to evaluate where omissions and errors occur in daily procedures that result in delayed and/or denial of requests for payment of services rendered.

By identifying areas of deficiency that need improvement, the physician practice can:

  • Improve cash flow and decrease turnaround days in accounts receivable by effectively capturing and coding charges,
  • Identify missed opportunity for services not billed; and
  • Provide education to providers and staff in areas of deficiency.

Audits should be performed on a regular basis and made a part of the practice's Compliance program. A Consultant will start out by selecting areas that are the most at risk in your specific practice.


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