Wiki Auditing help...

[wfriddle]

I have been working in my doctor's office for just over a year now. I came from a billing company prior and that was my first step into the world of medical billing. So this is my first experience working in a doctor's office. That being said when I started I learned the process as I went and did a lot of clean up and catch up from previous billers and changes made prior to my arrival. I have now gotten to a point were I feel like I need to make improvements rather than just continue on the way that my previous billers did things. The first thing that I have not heard mention of and that I feel that should be done is auditing. I have absolutely no experience in this and do not have the slightest clue as to where to begin. If anyone has some advice or some good resources on how to set up this process I would greatly appreciate your help.

 

[1topcat]

Auditing is a very overused and large term that when broken down translates into quality assurance. Essentially you determine what you want to audit. Such as E&M documentation compliance. Then you take a sample which can be statistically valid or a baseline such as say 10 charts from each provider for each level of service. Then applying one of the free auditing templates out on the web, you score the documentation to determine if they meet the elements that the guidelines dictate. You can audit anything you choose and go as crazy or as light as you have the time. However the most important element is to make sure that what ever you are auditing you apply it towards a documented standard such as 95 or 97 e&M guidelines. Second what to do with the results is the next step because auditing is a tool used to maintain compliance. do not audit if your practice is not interested in improving their skills and changing if necessary. Do not hesitate to email if you need a little more coaching. kathym@ahatopcat.com