Certified Medical Audits

DOCUMENTATION AND CODING AUDITS

The Office of the Inspector General (OIG) recommends that all practices have a preventive Documentation and Coding Audit at least once a year. A Certified Professional Medical Auditor will audit a sample of your charts and provide a detailed report comparing the codes billed with the code levels the documentation supports. We can then assist your practice in educating the providers in the proper documentation for the services provided and the codes billed.

Rebuttal Audits

Insurance companies are increasingly using chart audits to see if codes billed are properly documented. Refund requests for "overpayments" based on inadequate documentation is becoming common place. With Medicare, this can not only result in large pay backs from the physician, but also may be considered fraud. Our Certified Medical Auditors can perform a Rebuttal audit under the auspices of your attorney in order to mitigate the insurance companies claims.

We can provide documentation and coding instruction for each provider with the goal of making sure the provider is paid for the care given and will not be at risk for take back requests from the insurance companies.