Medical Coding Audits
Medical Coding Auditors: Certified & Independent
Complete and accurate coding is critical to the integrity of your medical records. Whether your group needs a complete record review or on-going audits, ConsensioHealth offers a complete audit service.
Why Independent Audits?
Every independent Emergency Medicine and Urgent Care group should be using periodic medical record audits to satisfy OIG compliance requirements and also as an ongoing measure of your practice's coding and billing efficiencies. Correct coding is the key to maximizing the allowable reimbursements your practice receives.
Clinical documentation standards are evolving. You need to keep up and the best way to keep up is through independent auditing of your documentation and EMR coding habits.
Here are three good reasons to do regular medical coding audits:
- They're Required: OIG Compliance requires regular independent audits to ensure coding matches the services for which claims are paid.
- They Identify Problems: Audits objectively analyze operations, detect holes in the coding process, and uncover system deficiencies.
- They Focus on Solutions: Audits pinpoint the documentation and coding training providers need to improve their coding habits.
Unlike internal medical coding audits, ones performed by ConsensioHealth are completely unbiased. We are certified medical coding auditors with a deep understanding of medical terminology (we're doctors too!).
Medical record audits focus on procedural and diagnosis code selection as determined by physician documentation.
Audits help you find ways to enhance clinical efficiency and they safeguard your group's financial position. You can use independent audits to:
- Protect against fraud
- OIG compliance requires regular audits to ensure coding matches the services for which claims are paid
- To find variances due to incorrect coding or incomplete documentation
- Among practitioners within your group
- Between your group and regional or national averages
- Identify and correct coding and documentation problems before you are challenged by insurance or government payers
- Identify when you’re not getting the whole reimbursement you deserve
- Find new opportunities for appropriate reimbursement
- Correct providers' use of outdated or incorrect codes
Once an audit uncovers where your coding isn't quite right, you'll be able to fix those problems. Audits pinpoint the documentation and coding education needed by providers with the intent of improving provider coding.