Wiki Chart Audit

[Lisa A]

Hello Everyone!

I was wanting to know if anyone is willing to share policy/procedure for physician chart audits?

Some of the quesitons I have are:

How many charts do you audit at a time per provider?
How often do you audit?
What do you do with the findings?
If the findings do not meet the expectations do you audit that provider more frequently?

Anything you can share about auditing in the physician practice would be great!

Thank you!!

 

[david.ennis@uwmf.wisc.edu]

Hi Lisa,
I work for a network of eye clinics, we have 23 OD's and 3 MD's. I am the only coder; I am also the internal auditor. When it is time for their annual compliance audit I take 20 charts spread out over a week. There audit is pre-submission to the payer, so any patient encounters that I find problems with I will have them go in and correct them. The audit scores as follows; 100-90 once every 12 months, 89-80 audit again in 9 months, 79-70 audit again in 6 months, 69-50 audit again in 3 months. If they score less than 50% then I will pull 10 more charts in 30days and audit them again.
As I said I am the only coder, but my providers do most of their own coding and if I see a pattern that needs attention I will address it at that time, and not wait for their next audit.
Hope this helps.
Thanks, Dave
david.ennis@deancare.com

 

[Lisa A]

Thanks Dave!

Any others out there that would like to share?