Audits: Does Your Documentation Support Services Billed?

Why This Topic Matters

Understanding audit workflows and documentation expectations helps practices reduce avoidable denials, respond appropriately to record requests, and strengthen billing compliance.

Article Sections

1. Know the Audit Types

   Introduces the major Medicare audit and review programs discussed in the article and describes the general ways they are carried out. It also notes the distinction between pre-payment and post-payment review activity.

2. NGS Found These E/M Errors

   Summarizes the evaluation and management services reviewed by NGS Medicare and the broad documentation issues identified in those reviews. The section focuses on the types of record-support problems affecting claim outcomes.

3. Take These Steps if You’re Audited

   Outlines general preparation and response topics for a Medicare audit, including record submission timing, coverage review, staff readiness, and documentation completeness. It also covers the value of clear records and notation support.