Looking Inward: Internal Audits

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  • In Billing
  • April 27, 2011
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A busy practice encounters a variety of costs in the day-to-day business of operating a clinic. For practices that provide costly medications or medical devices it is important to take steps to make sure these charges are captured and billed to insurance or patients for reimbursement. Some costs may seem minimal but add up over time. A focused audit could identify a significant loss of revenue.
Start by looking at invoices for one or two of the more costly devices used in the practice. Intrauterine devices (IUDs) are one expense in a gynecologic or family practice setting that should be monitored closely. Initiate a tracking system to make sure charges are posted for both the device (J7302, J7300) and the insertion of the device (58300).
Deciding on a procedure or service to monitor is not difficult and can identify significant financial windfall. Think through your appointment schedule and the services provided in the clinic. Here are some examples to start you on the road to recovery:

  • Make sure that injectables are billed with the correct units and the method of administration.
  • Run utilization for diagnosis of UTI (599.0), verify billing of UA. (81000-81003.
  • When Gyn procedures (LEEP, colposcopy, cervical biopsy) are performed in the office, verify billing of pregnancy test (81025).
  • Run utilization of joint injections (20600-20610) and verify accurate units of therapeutic agent. (J3301, Kenalog per 10 mg).

Capturing all charges is vital to the financial wellness of the practice. Evaluating the results of your audit may indicate a need to establish or fine tune clinic processes or re-training of staff. If you lack resources to do these audits, AAPC can help you. Call us.

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