It is crucial for a medical practice to be knowledgeable in medical coding as it impacts reimbursement and compliance. Our coding experts can assist your practice in providing education to optimize your understanding of medical coding as specified in coding guidelines. We also offer a thorough review of charts by means of an audit in which provider documentation is evaluated for completeness, accuracy and compliance of coding to include CPT, ICD-10-CM, HCPCS and modifier usage. We compile results and provide the best advice based on findings. Enlist our coding experts for your coding education and/or chart auditing needs.
Ensure correct reimbursements
Your patients’ health is not the only thing that needs regular reviews. You also must ensure you are correctly reimbursed and your coding practices not only impact your bottom line, but are also subject to documentation and compliance guidelines. Enlisting our coding experts to complete periodic chart audits and provide advice is a best practice that will positively benefit every aspect of operations.
Types of Audits Available
- Risk Based - This type of audit offers your practice a thorough analysis of your coding processes. We'll look at all the codes you are currently charging and compare them to national averages. Our goal is to give you the confidence that your coding practices are following best practices and eliminates your risk of inadvertently commiting fraud and being fined up to triple the damages.
In a recent audit, our client realized that they weren't correctly following the guidelines, even though they believed they were. Our audit findings showed that 41% of their revenue documentation didn't adhere to the guidelines. Luckily, we were able to find it early and they were able to correct their mistake and update their processes.
In some cases, clients may have to go back six years to update their billing practices in order to be complient with the full look back period. It is a lot of work, but well worth the effort.
- Focused - If you know you have a problem with your ICD-10 or E/M codes, then we can review the specific area that is challenging you to help you get things corrected.
- Regularly Scheduled Audit - Once evaluated, some clients sign on for recurring audits to ensure that they continue to follow best practices. The schedule and complexity of the audits can be customized to your needs.
Reviewed by Senior Industry Advisors
Our team of coders employs more than 35 years of institutional knowledge of coding to create personalized experiences that not only teach but lead your team through practices of establishing accurate coding. Our team works in conjunction with your medical providers, group practice professionals, medical coders, practice administrators and revenue cycle staff to ensure coding on all levels is compliant.
Schedule your chart audit today!
Simply fill out the form on this page and we'll be in contact to learn more about your needs and goals.
Questions We'll Ask
Audit Needs Assessment
If you are curious about the questions we'll be asking on our first call, here is the information that we'll want to know and it will help us focus our efforts for an efficient meeting:
- Does your practice have a compliance plan in place? If so, are regular chart audits a part of the plan?
- When was the last audit?
- Does your practice use certified coders for billing purposes?
- What type of coding training do staff and physicians obtain annually?
- Are you interested in learning which of your procedures are most at risk?
- Are you interested in documentation training for your providers?
- Are you interested in coding training for your staff?
- Are you interested in developing policies and procedures for documentation which can mitigate risk in case of an audit?
- What are you trying to accomplish with an audit?
- To ensure billing accuracy in order to avoid penalties.
- To meet internal compliance program requirements.
- To mitigate risk of CMS, RAC, or other regulatory audit.
- To ensure charge capture and improve revenue.
- To improve clinical documentation for continuity and quality of patient care.
- How are you paid for the services you provide?
- Fee for service
- Outcomes based / value based
- Which code sets would you like to include in the audit?
- Evaluation and Management Services (E/M)
- CPT codes (other than E/M)
- HCPCS codes
- ICD-10 codes
- Has your practice submitted voluntary paybacks for known overpayments?
- Has your practice been audited by a government or commercial payer?
- What is your desired timeline for auditing and training services?
- Are there any coding, billing, or auditing concerns we should be aware of?