Q/A: Do you Have any Recommendations for Audit Prevention?

by  Melissa Hall
June 7th, 2016

Answer:

Yes. The best prevention for audits is to be proactive. It is much easier on a practice to find and fix their own errors and oversights versus waiting until an audit or records review when the 3rd party payer will surely find the errors/oversights and notify you - usually in the form of a request for refund.

As a measure of risk management, and also to adhere to compliance guidelines, practices should at least once per year perform a File Review. The File Review evaluates your documentation, coding and billing and enables your practice to prevent errors, find and fix errors before they become long-term and costly challenges, and provides necessary training and education of current guidelines.

If practices have confidence in their own abilities to conduct the file review, it is okay to do so and is recommended to review multiple random charts of different case types. Otherwise, you may outsource your File Review to a professional organization that is certified and experienced with this process and the necessary guidelines for documentation, coding, billing, payer policies, etc.