Tip: Start at the top and work down. Medical offices that are striving for the most accurate billing practices should conduct internal chart audits at least twice a year on each physician, but how do you get started? Inventing a chart audit system from scratch may appear to be a daunting task -- but you can pull it off with careful planning and the proper resources. Consider these expert tips for formulating your own internal chart audit system. First, Get Staff on Board The most important step in internal audit planning is also the first one. Before beginning your audits, you need to get buy-in from the chief of the department, the senior partners, and then all the other physicians. Once you have the buy-in from all the physicians and the support of the senior staff, you should then present the internal audit plan to the other staff so that everyone is aware of what is going to happen. Next, Tighten Audit Focus After you've prepared staff for the auditing process, you'll need to narrow the parameters of your audit. You can achieve this by: Then, Check Federal Resources Once you set the internal audit focus, decide which codes to concentrate on, experts say. When you do this, remember that a practice's top-20 high-volume codes typically account for 80 percent of its reimbursement. So focusing on these 20 codes is a good place to start. You should also consider the Office of Inspector General (OIG) work plan when deciding where to focus your energy. The OIG plan, designed to help practices adhere to federal guidelines when billing, is online at http://oig.hhs.gov. What is it?