ED Coding & Reimbursement Alert - 2006 Issue 8
AUDITS: Look For Time Bombs In Your Medical Records
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Article Overview
This article discusses how physician practices can approach chart audits as part of compliance and revenue protection efforts. It focuses on broad audit planning concepts, sampling methods, comparison to national evaluation and management patterns, specialty-society guidance, legal review of audit results, and the role of medical necessity. It is written for coders, auditors, compliance staff, and practice managers who want a general framework for reviewing documentation and billing patterns.
Why This Topic Matters
Regular chart auditing can help practices identify documentation and billing mismatches, support compliance efforts, and reduce risk. The article is relevant to readers looking for general audit strategy rather than code-specific instruction.
Article Sections
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8 tips to improving your chart audit success
Introduces general chart audit planning for physician practices and frames the discussion around compliance, documentation review, and revenue protection.
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Use These National Benchmarks
Discusses comparing a practice’s evaluation and management patterns against broader national data and benchmarking resources.
What You Will Learn
- How chart audits can support compliance and documentation review
- General ways to structure a sampling approach for audits
- How national benchmarking may be used in audit review
- Why specialty guidance and legal review may be relevant to audits
- How medical necessity fits into chart review planning
- When to consider outside help for audit-related questions
Who Should Read This
- Medical coders
- Compliance staff
- Practice managers
- Physician office administrators
- Audit and reimbursement professionals
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