| Could you pass an audit if a payor auditor came | | | | a variety of services which should include E/M |
| into your practice to see charts that were paid | | | | services, consultations, surgical procedure and any |
| on? Every practice should perform an In House | | | | hospital services. |
| Audit to evaluate your practice compliance and | | | | In your audit, review the supporting |
| billing procedures before someone else does. | | | | documentation, physician notes, billing history, |
| Audits can be time consuming and a pain in the | | | | EOB's and physician orders. Review the services, |
| neck--but these should be done on a routine basis | | | | date ranges, incident-to-billing, modifier used, and |
| to ensure that your practice is where is should be | | | | consultations to name a few. These are the things |
| before an outside auditor comes through your | | | | that an outside auditor is looking for. |
| front door. | | | | Make sure that your staff who is reviewing these |
| Internal audits can ensure that your billing and | | | | charts is well aware of the E/M coding, also make |
| coding is in compliance and may even save you | | | | sure that the physician is in the correct time |
| money. The audits will also uncover any | | | | frame for the procedure. Make sure that they |
| inconsistencies in your documentation and in the | | | | are not down coding or up coding, as either of |
| coding, which will then help your practice in | | | | these will cause red flags. |
| knowing where your staff needs more education. | | | | Your goal should be to help get each provider and |
| Internal audits should be performed at least once | | | | biller as close to 100 percent compliance and |
| a year, but you can determine this by the size of | | | | accuracy. |
| your practice and in the findings from the first | | | | Without doing In House Audits you have no idea |
| audit. If your audit shows a lot of errors, you | | | | how your practice is doing on compliance issues, |
| might decide to do an audit every six months or | | | | compliance guidelines or regulations. Finding |
| every three months, until you are satisfied that | | | | problems early will help reduce your risk. |
| your practice can pass an outside auditor. | | | | The internal audits will also point out when and if |
| You should pull at least 20 patient charts per | | | | you need to bring someone from the outside in |
| provider for your audit. These charts should have | | | | to help your practice and finding the problems. |