decisionhealth Newsletters, Part B News - 1999 Issue 10 (October)
Know your numbers: a practice profile can help you self-audit
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Article Overview
This article discusses practice-level statistical profiling as a tool for self-auditing coding patterns, with emphasis on evaluation and management utilization, comparison against specialty and regional norms, and the role of internal chart review. It is aimed at physicians, coders, compliance staff, and consultants who want a broad understanding of how utilization analysis can support documentation review and staff education without changing coding solely to match averages.
Why This Topic Matters
Understanding how practice profiles are used can help organizations recognize potential compliance concerns, plan internal reviews, and better align documentation and coding oversight with broader audit expectations.
What You Will Learn
- How statistical profiling can be used to review practice coding patterns
- Why comparison with specialty and regional norms matters in compliance monitoring
- How utilization analysis can help identify areas for chart review and staff education
- What roles consultants and carriers may play in generating or interpreting practice profiles
Who Should Read This
- Physicians
- Medical coders
- Compliance officers
- Practice managers
- Coding consultants
- Revenue cycle staff
Codes Discussed
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