BC Advantage - 2015 Issue 10
What to Expect From an Audit Report
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Article Overview
This article is about audit report structure in medical coding compliance, with emphasis on how third-party documentation and coding audits are commonly summarized and presented. It is useful for practices, providers, auditors, and compliance staff who want to understand the general scope of audit deliverables, the kinds of feedback often included, and why report format can affect education and follow-up. The discussion stays at a high level and focuses on broad categories of audit reporting rather than detailed coding rules.
Why This Topic Matters
Audit reports can influence provider education, compliance workflows, and the handling of identified issues. Understanding the typical parts of a report helps practices set expectations before an audit and evaluate whether the reporting format supports useful feedback.
Article Sections
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Overview of the Findings or Summary
Discusses the summary portion of an audit report and the kinds of high-level findings that may be included. It emphasizes how reporting format can affect provider understanding and the educational value of the audit.
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Up-Code/Down-Code Report
Describes the detailed report section that tracks audited encounters and the reported outcomes of the review. It also notes the kinds of supporting information that may appear in this part of the audit documentation.
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Record Commentary
Covers written auditor comments tied to the reviewed records and their role in provider education. The section focuses on how narrative feedback can supplement the findings summary.
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Productivity Analysis
Addresses broader analysis of service utilization and related audit risk patterns. It discusses how this type of reporting may extend beyond a single encounter review.
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Disclaimer
Notes the importance of report disclaimers and their relationship to audit follow-up expectations. It also highlights the role of report language in framing practice responsibilities after an audit.
What You Will Learn
- What sections are commonly found in an audit report
- How audit summaries and detailed findings are generally organized
- Why written auditor commentary can support education
- How productivity analysis may be included in a broader audit review
- Why disclaimers matter in audit reporting and follow-up
Who Should Read This
- Medical practices
- Physicians and other providers
- Medical coders
- Compliance officers
- Auditors
- Practice managers
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