Wiki Ob/gyn Audit

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ascordilis

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Help! I am new to OB/GYN and my MD's want me to do a practice audit, which would include chart audits, to help them understand why they are losing $$ Do any of you have templates, guidelines-I am appreciative for anything. I'm starting from scratch...:eek:
 
Try going to your local medicare carrier for your ob guidlines. I would also refer to my CPT guidlines. I'm sorry I cannot help you out with any templates but try googling for ob chart audit templates.
 
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If your doctor is losing money is it because the number of patients changed? I would start by comparing the type of insurances your recent patient have. Did you see more Medicaid patients this year compared to last year? Keep a better check on the prgoress of your patients... with pateints that have insurances using global codes if another doctor delivered your patient are you going back and billing the visits? this is where I would start.
 
When you say'refer to my CPT guidelines' are you referring to the guidelines in the 2008 CPT book or another resource? Thanks!
 
Thank you so much for that advise. I will look into those:
1) # of patients changed fom one year to the next
2) Increase in Mediciad patients?
3) Global OB patients billed out per visit if not delivered by us

Please let me know in this speciality if there are any other areas that come to mind that comparing yearly P/L's won't show me. Thanks!!!!
 
A couple of other things to check:

Were balances written off along with allowed adjustments? Legitimate balances (pt's portion, deductibles, copays, etc) not collected can make a hugh difference also.

What is your payor mix? Did it change recently (due to a major employer changing insurances is one example).

Also, you want to make sure the practice is collecting all copay and pt responsibility up front that you can, saves a lot of postage and collection costs. Little things can have a tremendous effect on A/R.

Good luck,
Machelle
CPC, CPC-H, CPC-E/M
 
Another thing you will need to do is look at the contracts your physicians signed with each Insurance and understand their policies regarding OB. When you start researching this you will see that each carrier has specific ways they want certain scenarios billed. Some of the larger carriers have their policies posted on their websites for easy access.
 
Lisa, I have some audit forms specific to OB-GYN if they will help - I do not have a scanner but would be happy to fax them to you if you want. Just furnish the fax number. Good luck!
 
Lisa, I tried to fax this to 423-990-2496 this AM and received a call stating they do know know you........is there another fax number?
 
Audit forms

Hello there. Is there a possiblity that you could fax these to me as well? My fax number is 217-223-9172 attn Jill.

Thank you so much!
 
Lana, I am also working with a gyn practice and staring to audit some of their charts, could you also fax me the audit forms specific to OB-GYN? My fax number is 336-553-2375.
Thanks
C.Robinson
 
OB/GYN Audit forms

LanaW said:
Lisa, I have some audit forms specific to OB-GYN if they will help - I do not have a scanner but would be happy to fax them to you if you want. Just furnish the fax number. Good luck!
Click to expand...

Can you fax these forms to me as well. Thanks.
Dwlinda
Fax 480-4443423
 
Ob/gyn audit

LanaW said:
Lisa, I have some audit forms specific to OB-GYN if they will help - I do not have a scanner but would be happy to fax them to you if you want. Just furnish the fax number. Good luck!
Click to expand...


Lana could fax it to me also if you still have available. I would great appreciate it. 605-312-5694. Thank you. :)
 
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