In today’s complex reimbursement environment, maintaining integrity and accuracy of information in the medical record is paramount to ensuring high quality patient care, compliance with regulatory standards and capturing the appropriate revenue for the services provided. This presentation is designed to review all the steps in an effective audit process.
According to CMS, E/M services comprise 40% of allowed charges in the physician fee schedule, 20% office visits and 20% other E/M services. Medicare’s expense is medical practice revenue, with the income from some primary care practices comprising 70% or more of total charges. To protect the organization, compliance professionals can focus on key components of E/M: During this training, we focus not only on the guidelines, but also on including the grey areas of auditing and how to address these with a policy for your organization.
Learning Objectives:
- Identify the importance of having an effective audit process
- How audits help to identify compliance, legal, and ethical standards
- Discussion of the methodologies of the auditing process
- Identify areas for improvement in clinical documentation
- Provide feedback regarding audit results
- Training and support for providers post audit
Areas Covered in the Session:
- Define the auditing process
- Why we audit
- Regulatory reasons to audit regularly
- Preparing for the audit
- Internal vs external audits pros and cons
- Performing an audit
- Pre audit functions
- Performing audit functions
- Post audit actions
- Reporting results
- Training
- On-going auditing
- Live Q&A Session
Suggested Attendees:
- Coders
- Auditors
- Billers
- Healthcare Administrators
- Office Managers
- New and Existing Front Office Staff
- Physicians and Nurses
- Non-Physician Practitioners
- Safety and Security Officers
- Medical Officers
- Practice Managers
- Safety Manager
- Compliance Officers
- Hospital and Medical Staff