Documentation & Coding Audit Review - DoctorsManagement (2024)

Medical coding accuracy is essential to your organization’s revenue cycle and compliance efforts. Theaudit and review processcan ensurecompliance and accuracy, enabling you to mitigate risks andensure the accuracy ofyour revenue. DoctorsManagement, LLC offers comprehensiveaudit and reviewservices to help you improve medical coding and documentationto ensure revenue stability.

A coding and compliance auditreview analyzescoding and documentation practicesto ensure accuracy, reliability and effectiveness. A coding auditreview examines documentation with a two-prong approach:

1. Documentation is analyzed to the payor reimbursem*nt policies to ensure accuracy and create a sustained revenue cycle.
2. Medical coding and documentation must also be scrutinized to coding and e&m billing rules and guidelines to assess the accuracy of your compliance. Audit reviews can reveal areas of risk and educate providers and staff about recent changes to rules and regulations.

Correct coding is the pathway to accurate reimbursem*nt and maintained compliance. For this reason, aneffective auditreviewprogramwill ensure the accuracy of both revenue and compliance.

Our Medical Billing and Coding Audit Services

DoctorsManagement is committed to the success of your audit and review process. Our expert auditing team performs accuracy reviews for medical coding that simulate an actual carrier audit, allowing you to address deficiencies and lower risk accurately. We customize our audit services to address your needs or project. Our process follows these steps:

1. Information collection:Our team willadvise on sample size and structure in an effort to provide a comprehensivereviewof all service lines provided per physician and non-physician-qualified provider.
2. Data analysis:We willanalyze the coded service as compared to thedocumentationsupportto identify areas of proficiency and deficiencywithin compliance and also with respect to reimbursem*nt. These reports provide claim-live-level feedback and are a standarddeliverable we provide with all our audits.
3. Extensive report of findings: Our auditors can provide a more specified coding audit results and recommendations report. This report includes the data analysis findings and recommendations as an overview with site and sourced published rules and guidelines. We recommend this report for audits that include deficient precision scores for compliance purposes.
4. Feedback training session: We recommend feedback training sessions based on the healthcare coding and compliance audit outcomes. Audit reviews that meet proficiency standards can be addressed collectively in group sessions, conserving budget expenditures. Audits found having deficient precision standards allow for designated one-on-one training to ensure understanding and acknowledgment of ongoing modifications necessary for compliance and accuracy in reimbursem*nt.

The Importance of Medical Coding and Audits

Medical coding accuracy can affect several aspects of your practice, including your compliance risk and revenue stream. Auditing can assist with improving coding quality and documentation support, enabling you to lower risk and ensure accuracy of revenue. Coding audit reviews can help your organization:

• Identify current documentation, coding, and reimbursem*nt policies and guidelines
• Locateservices not reported and untapped areas of reimbursem*nt
• Correctmisuse of electronic medical records within documentation

By implementingregular auditreviews and analysis to provide ongoing improvement checks foryour coding and documentation practices, your organization can experience benefits such as:

• Maintained compliance: Audit reviews can address coding compliance concerns within your documentation and coding processes. They enable you to stay updated on new laws and regulations and may help you identify areas of risk for improvement to mitigate claim recoupments.
• Saved time and money:Accurately codedand documentedclaims can lead to fewer rejections and denials. Audits help you quickly identifyand correct such concerns and issuesso more cases can be paid fully and on timewhile eliminating the duplicative work caused by denials.
• Improved internal processes:Coding auditreviewscanuncoverimprovement opportunitiesto include efficiencies in processes and reimbursem*nt. Ongoing annual audit reviewsensure your organization is following proper internal processes and procedures that result in quality medical coding.

Why Choose DoctorsManagement for Medical Coding Audits?

As a full-service consultancy firm located in the U.S. with all U.S.-based team members, DoctorsManagement has the auditing expertise and resources to help a variety of organizations, including solo practices, group practices, multi-specialty clinics, hospitals and large integrated health systems. Our highly skilled and experienced medical coding auditors can assist you in identifying and correcting deficiencies within your coding and documentation processes. We have specialized team members to provide support in all specialties and sub-specialty for adult and pediatric medicine.

We have access to proprietary technology to assess your critical risk areas and recommend adjustments that can help you mitigate risk, reduce coding errors and address your revenue streams.

Contact Us To Audit Your Medical Billing and Coding

When you need a customized coding audit plan that meets your goals, lowers your risk and boosts your revenue, you can trust DoctorsManagement to deliver coding and documentation support. Contact us onlineto discuss your audit needs.