Audit Quick Check

The principal Medicare carrier function is to make payments to providers, and to deny or reject payment if the practice's billing pattern is atypical and cannot be supported by the physician or practice involved. This determination is made through regular carrier audits of medical records to determine compliance.
If you answer no to one or more of the following questions, you may be at risk of an adverse audit and should think about having Rose & Associates conduct a full base line audit of your patient medical records.

1. Does the Subjective entry of the patient chart always contain a chief complaint, symptom or medically necessary reason for the care provided?
2. Does your Patient Authorization form include the required Medicare language?
3. Are chart entries in ink, legible and signed?
4. Does each page of the chart sheet or EHR printout contain the name and date of each patient?
5. Are the elements appropriately documented for the level of exam billed?
6. Are the test results in the patient chart? If not, is their location noted?
7. Is the final diagnosis or provisional diagnosis always noted in the patient chart?
8. Is a separate interpretation and report included in the patient chart for diagnostic tests that require one?
9. Do your comprehensive ophthalmic exams note the initiation of a therapeutic or diagnostic treatment program?
10. Is a copy of the operative or procedure report included in the patient chart?

 

Regular chart audits can help reduce the risk of an adverse Medicare audit and help eliminate the possibility of filing fraudulent claims. Click here for more information about our chart audit services.

You may also contact us or call (800) 720-9667 for additional information.