Documentation & Coding Audit Review
Medical coding accuracy is essential to your organization’s revenue cycle and compliance efforts. The audit and review process can ensure compliance and accuracy, enabling you to mitigate risks and ensure the accuracy of your revenue. DoctorsManagement, LLC offers comprehensive audit and review services to help you improve medical coding and documentation to ensure revenue stability.
A coding and compliance audit review analyzes coding and documentation practices to ensure accuracy, reliability and effectiveness. A coding audit review examines documentation with a two-prong approach:
- Documentation is analyzed to the payor reimbursement policies to ensure accuracy and create a sustained revenue cycle.
- Medical coding and documentation must also be scrutinized to coding and e&m billing rules and guidelines to assess the accuracy of your compliance. Audit reviews can reveal areas of risk and educate providers and staff about recent changes to rules and regulations.
Correct coding is the pathway to accurate reimbursement and maintained compliance. For this reason, an effective audit review program will ensure the accuracy of both revenue and compliance.
Our Medical Billing and Coding Audit Services
DoctorsManagement is committed to the success of your audit and review process. Our expert auditing team performs coding audit reviews that simulate an actual carrier audit, allowing you to address deficiencies and lower risk accurately. We customize our audit services to address your needs or project. Our process follows these steps:
- Information collection: Our team will advise on sample size and structure in an effort to provide a comprehensive review of all service lines provided per physician and non-physician-qualified provider.
- Data analysis: We will analyze the coded service as compared to the documentation support to identify areas of proficiency and deficiency within compliance and also with respect to reimbursement. These reports provide claim-live-level feedback and are a standard deliverable we provide with all our audits.
- Extensive report of findings: Our auditors can provide a more specified findings and recommendations report. This report includes the data analysis findings and recommendations as an overview with site and sourced published rules and guidelines. We recommend this report for audits that include deficient precision scores for compliance purposes.
- Feedback training session: We recommend feedback training sessions based on the audit outcomes. Audit reviews that meet proficiency standards can be addressed collectively in group sessions, conserving budget expenditures. Audits found having deficient precision standards allow for designated one-on-one training to ensure understanding and acknowledgment of ongoing modifications necessary for compliance and accuracy in reimbursement.
The Importance of Medical Coding and Audits
Medical coding accuracy can affect several aspects of your practice, including your compliance risk and revenue stream. Auditing can assist with improving coding accuracy and documentation support, enabling you to lower risk and ensure accuracy of revenue. Coding audit reviews can help your organization:
- Identify current documentation, coding, and reimbursement policies and guidelines
- Locate services not reported and untapped areas of reimbursement
- Correct misuse of electronic medical records within documentation
By implementing regular audit reviews and analysis to provide ongoing improvement checks for your coding and documentation practices, your organization can experience benefits such as:
- Maintained compliance: Audit reviews can address compliance concerns within your documentation and coding processes. They enable you to stay updated on new laws and regulations and may help you identify areas of risk for improvement to mitigate claim recoupments.
- Saved time and money: Accurately coded and documented claims can lead to fewer rejections and denials. Audits help you quickly identify and correct such concerns and issues so more cases can be paid fully and on time while eliminating the duplicative work caused by denials.
- Improved internal processes: Coding audit reviews can uncover improvement opportunities to include efficiencies in processes and reimbursement. Ongoing annual audit reviews ensure your organization is following proper internal processes and procedures that result in quality medical coding.
Why Choose DoctorsManagement for Medical Coding Audits?
As a full-service consultancy firm located in the U.S. with all U.S.-based team members, DoctorsManagement has the auditing expertise and resources to help a variety of organizations, including solo practices, group practices, multi-specialty clinics, hospitals and large integrated health systems. Our highly skilled and experienced medical coding auditors can assist you in identifying and correcting deficiencies within your coding and documentation processes. We have specialized team members to provide support in all specialties and sub-specialty for adult and pediatric medicine.
We have access to proprietary technology to assess your critical risk areas and recommend adjustments that can help you mitigate risk and address your revenue streams. Our sophisticated 2023 E/M audit tool, Compliance Risk Analyzer® (CRA), allows our team to select and address the encounters that are most likely to trigger a carrier audit.
Contact Us Today
When you need a customized coding audit plan that meets your goals, lowers your risk and boosts your revenue, you can trust DoctorsManagement to deliver. Contact us online to discuss your audit needs.