Develop an E/M audit structure that works for your organization

Why This Topic Matters

A well-designed audit structure helps practices identify documentation and billing risk, support education, and create a repeatable compliance process. It also helps leadership decide how to sample records, track findings, and schedule follow-up reviews in a consistent way.

Article Sections

1. Audit structure basics

   Introduces the core elements used to design an evaluation and management audit program. Covers the general purpose, scope, and risk considerations that shape the audit approach.

2. Choosing an auditor

   Discusses the attributes and experience to look for when selecting the person who will conduct the audit. Emphasizes communication, coding background, and professionalism.

3. Making preaudit preparations

   Describes planning steps to complete before the audit begins, including coordination with leadership and documentation of the planning phase.

4. Deciding when to audit

   Reviews the differences between prospective and retrospective review approaches. Summarizes how timing affects workflow, staff education, and the handling of findings.

5. Establishing a baseline

   Explains how a baseline review can help a practice understand current risk and plan future audit activity. Covers several ways to organize the baseline review across the practice.

6. Tracking audit results

   Outlines categories of information a practice may want to monitor during an audit. Focuses on building usable reporting that supports follow-up and trend analysis.

7. Establishing an audit cycle

   Discusses how often audits may be performed and how follow-up reviews can be scheduled. Includes the use of thresholds, targeted reviews, pilot testing, and post-audit reporting.