Coding and Compliance
MD Coding Audit is a service developed to assist physicians, nationwide, in accurately billing for services rendered. If your practice is "under-coding", our audits will significantly improve your practice revenues. If your practice is "over-coding", we can help save you from health plan penalties and possible fines from CMS (formerly HCFA) by clarifying specifics for each of the three E&M categories (History of Present Illness, Exam and Medical Decision Making) and making suggestions based on the information found in the initial audit.
We have Certified Professional Coders (CPCs) on staff and all the tools necessary to assist your office with an initial chart audit and if desired, the successful implementation of a compliance program.
Chart Audits
MD Coding Audit has a proven track record to facilitate in the accuracy of physician chart documentation. We have Certified Professional Coders (CPCs) on staff with 20+ years combined health care experience. They are up-to-date on current guidelines from AMA, CMS (formerly HCFA) and the OIG. The current process includes a baseline audit, education session (Customized Tutorial CD) and a scheduled follow-up audit. Our baseline audit will show the practice if the current documentation matches the level of service billed. The audit reports include:
- Executive Summary with pluses and minuses of findings and dcoumentation.
- Practice comparison information at a group and individual level, broken down by CPT Code.
- A cost analysis of coding errors comparing to the current Medicare Fee Schedule.
- Detail to reflect which of the documentation areas need additional monitoring (HPI, Exam, MDM).
The customized tutorial CD breaks down every facet of the auditors' worksheet, including your practice results and tests your coding skills with multiple case studies. The follow-up audit reinforces the findings from the baseline audit and shows the improvement after the education has been completed.
Using the 1997 Chart Documentation Guidelines, PHD results to date reflect physician offices completing all three steps (Initial Coding Audit, Education, and a 90-day follow-up audit) have shown an improvement of up to 60%.
Coding Compliance
We have developed a customized compliance program that can easily be adopted by almost any practice. With Certified Compliance Officers (CCOs) on staff and the current package that we offer, we have all of the tools necessary to assist any office with the successful implementation of a compliance program. The compliance program includes all of the "Seven Key Components" recommended by the OIG.
- Auditing and Monitoring
- Establishing Practice Standards and Procedures
- Designation of a Compliance Officer / Contact(s)
- Conducting Appropriate Training and Education
- Responding to Detected Offenses and Developing Corrective Action Initiatives
- Developing Open Lines of Communication
- Enforcing Disciplinary Standards through Well Publicized Guidelines
Contact us today to learn more |
