Practice Management Alert

First audit will show you which practitioners need more education

Medical offices that are looking to start, or overhaul, their own internal audit system have to begin with the basics, and the baseline audit is the best first step.

Why? With the information gleaned from a baseline audit, you-ll be able to streamline future auditing efforts and focus them on the most important areas to your insurers.

Assume a 6-Month Interval to Start

When deciding how often to perform an internal chart audit, assume you will review each practitioner in the practice twice a year, says Susan Hvizdash, CPC, CPC-EMS, CPC-EDS, physician educator for the University of Pittsburgh Physicians department of surgery and AAPC National Advisory Board Member.

First step: Before deciding on a biannual audit frequency, you should conduct a baseline audit--the term for the first comprehensive audit your practice performs, says Deborah Grider, CMA, CPC, CPC-H, CPC-P, CCS-P, CCP, EMS, president of Medical Professionals Inc. in Indianapolis and AAPC National Advisory Board president-elect.

Why? Some billers, coders and physicians may need more frequent auditing than others, Grider says. Grider says she usually performs a baseline audit the first time she audits a practice. She then studies that data and decides whether to audit each provider -quarterly, semi-annually, or annually.-

Example: You are conducting a baseline chart audit for Provider X. The results show that his chart compliance is less than 60 percent for the last six months. For Provider X and other practitioners lagging in chart compliance, -it would be more beneficial to conduct quarterly audits until compliance is [at least] 90 percent,- Grider says. 
  
Best bet: Your goal is to get your providers as close to 100 percent compliance as possible. Assume you will audit each biller twice a year. Then, perform a baseline internal chart audit to see if anyone is abnormally low in the compliance department. Consider conducting coding education sessions, followed by more frequent audits, for anyone with compliance problems.