Wiki Audit systems

[coder1]

Good Afternoon,

Does anyone use or know a audit system that generate workflows constantly? Our company have a EMR that was built for our practice. Right now, I wait until my manager give me audits to conduct. Any suggestions will be helpful. Thanks in advance

 

[amberlarsen820]

I recently started auditing at my workplace....No one had done it before me.

I really don't have that good of an auditing system in place, but it works for what I need it to. I don't know what EHR you guys have, but we use Pulse Systems.

I run stat reports on the specific codes (99221, 99222, 99223, 99211, 99212, ect...) I do audits on hospital initial consults, rounds, and office visits. I run a report on the code I want to audit. The system separates the codes by the provider. I will pick a couple random patients and pull the charts and audit those ones. I try to get a variety of code levels on each audit for each doctor. I am only auditing about 6 for each provider (I am turing in audits on a weekly basis).

I know this isn't the best system, but this is how I run my audits. I don't know if this helps any. If anyone else has any suggestions on this, I would love to hear them!

 

[Titali80]

Me too. I just recently started auditing hospitalist charts. I will share my plan for chart audits tomorrow or so. but yes i am focusing on 1 physician different level codes at different facility during different time period and see what is he missing in his documentation and whatever he coded the level has met criteria according to medicare guidelines.

 

[suemt]

I've been doing E/M Coding Reviews for a practice for a couple years now. They are affiliated with a large hospital system and run EPIC, which has a mechanism to select a certain percentage of visits per provider for review. The selected visits are put into a separate work queue.

As I work each visit, I can either release to billing, or if there is an issue, I can message the doctor to make corrections. Once the corrections have been made, I review the visit again.

There are a few glitches, and it is probably more clicks that would be ideal for maximized workflow, but overall it works well.

Otherwise I wind up with more manual processes as you've described.