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.