What does proper scheduling and scrutinizing documentation have to do with your success? Self audit is a process. Before you jump in and take on the job, you need to prepare yourself and your staff for it. As you may probably know, government payers are not the only insurers who perform audits. Private insurance companies also audit practices, so you should make sure that your gastroenterology office will be left hassle-free should an auditor pay a visit. Sense of purpose: Demythologize some essential elements of self audit that are embedded within the following fabrications. Myth 1: Internal Audits Get Staff In Dire Straits Internal audits are a way to make sure you are on track and nothing has gone awry, so you need to let every member of your practice " including physicians and non-physician practitioners -- why you're doing an internal audit. Because of the stigma that the word "audit" brings to most people, youwould probably have to remind them that you aren't trying to get anyone in trouble. Instead, you want to determine whether they're helping to bring in the right amount of payments and cutting out denials. Everyone in your practice should realize that there's light at the end of the tunnel: Internal audits can spawn opportunities for education, opportunities for the development of better forms, and opportunities to tune up the practice. In addition, internal chart audits make it possible to find and correct coding errors and self report, rather than letting the payer find them. Reality: In fact, a large percentage of the audit focuses on the doctor's documentation, not how the coders and their managers are doing their jobs. "If staff members are having a fear of losing their jobs, they are misinformed," says Susan Vogelberger, CPC, CPC-H, CPC-I, CMBS, CCPP, CEO of Healthcare Consulting & Coding Education, LLC. "Physicians are happy to improve documentation because it keeps them from a government audit by not raising flags, and it often brings in more revenue." Myth 2: All Audits Have The Same Approach In fact, there are two types of internal chart audits your practice needs to look at before determining which will work best in your office: A prospective audit helps you identify and correct problems before sending the claim, which could mean you'll discover incorrect coding or charges that would otherwise have been missed. Keep in mind that this type of chart audit can potentially delay billing, however. Alternative: Your practice must determine for itself what types of audits your staff can reasonably complete and what effects on claimsubmission timing and cash flow the practice can handle. When reviewing charts -- most auditing specialists recommend that you review 10 to 15 records per physician during your audit -- you should examine the documentation and determine which ICD-9 and CPT codes you think apply to the chart, then check which codes were actually assigned to the services. Myth 3: End and Begin Audits Whenever You Please Schedule gives life to the whole internal audit process, without it all your efforts might go to waste. Depending on the size and type of your practice, you should decide how often your practice performs an internal audit. Consider the amount of resources the practice can devote to the audit while simultaneously conducting day-to-day office business. Pointer: Tip:
. Which providers, services, date range, and payers will it address?