Total Compliance Solution
DoctorsManagement assists organizations of all sizes (including Hospitals, Physician Group Practices, Health Systems, ASCs, Rural Health Centers, FQHC’s and more) with all levels of regulatory compliance from coding and billing documentation, auditing, human resources, reporting, staff and provider training, OSHA and HIPAA auditing and training, and if necessary, demand audit, assistance with claim investigations, insurance audits, reporting, expert witness defense, and appeals.
Proactive Compliance Services
- Chart Audit
- Coding Audit
- Audit Services
- Production Coding
- Medical Record Review
- Provider Documentation Review and Education
- Coding Accuracy
- ICD diagnoses and CPT service codes
- Over-documentation Review
- Predictive Analytics
- Compliance Risk Analysis
- Customized OIG Compliance Programs
- Third-party Compliance Officer Services
- Audit Reporting
- Missed Charge Opportunity (MCO)
- Audit Training
- HR Compliance
- OSHA Compliance consulting and training
- HIPAA Compliance consulting and training
- Laboratory Compliance | CLIA
Post -Demand Services
Do you have a Compliance Management Program in place?
Your Total Compliance Solution represents a comprehensive compliance program for your medical practice or healthcare facility. Whether you’re a solo practice or a large hospital or health system, having a corporate risk and compliance management program in place has become a requirement for doing business in today’s healthcare marketplace.
Made up of a suite of complimentary services, your Total Compliance Solution will help to ensure that your policies and procedures are properly developed, based on the unique needs of your organization, and implemented in a way that sets the stage for success and supports you in the on-going management of your compliance management and risk reduction efforts.
A Baseline Coding and Compliance Audit
Our team performs a retrospective audit to review of your current coding, billing and documentation procedures. This audit is conducted in a way that closely simulates an actual carrier audit. We compare your existing practices to CMS and National Guidelines as well as the medical necessity of the encounters. A distinct advantage that our team has over other firms is access to our proprietary risk assessment tool, Compliance Risk Analyzer (CRA), which identifies encounters that demonstrate high and moderate risk, allowing and helps identify outliers and aberrant coding patterns that typically trigger an audit.
We report on your evaluation and Management (E/M) coding accuracy, documentation, accuracy of procedural coding, accuracy of modifier assignment, bundling as well as potential issues with your Electronic Medical Records (EHR) such as faulty templates. Our report includes recommendations to correct the issues as well as recommendations for training to help mitigate future risk.
Compliance Plan Development and Gap Analysis
Many organizations find it both time-consuming and confusing to attempt to develop a comprehensive compliance plan on their own. Off-the-shelf packages, however, often leave much to be desired can be difficult to implement properly. As a result, clients turn to us to build a comprehensive plan for their organization. Having worked with all sizes of facilities; from the single-physician practice to systems with hundreds of physicians in every specialty, you’ll find that a custom compliance plan can help you save time, money and potentially reduce liability.
What to do next…
Contact us to discuss your coding and audit needs by calling (800) 635-4040 or email [email protected].
Read more: What can you expect from a coding and compliance review?
Here’s why thousands of providers trust DoctorsManagement to help improve their coding and documentation.
Quality of coders and auditors. Our US-based auditors receive ongoing training and support from our education division, NAMAS (National Alliance of Medical Auditing Specialists). All team members possess over 15 years of experience and hold both the Certified Professional Coder (CPC®) as well as the Certified Professional Medical Auditor (CPMA®) credential.
Proprietary risk-assessment technology – our auditing team uses ComplianceRiskAnalyzer(CRA)®, a sophisticated analytics solution that assesses critical risk areas. It enables our auditors to precisely select encounters that pose the greatest risk of triggering an audit so that they can be reviewed and the risk can be mitigated.
Synergy – DoctorsManagement is a full-service healthcare consultancy firm. The many departments within our firm work together to help clients rise above the complexities faced by today’s healthcare professionals. As a result, you receive quality solutions from a team of individuals who are current on every aspect of the business of medicine.